1073664678 NPI number — SCIODE MEDICAL ASSOCIATES, PLLC

Table of content: (NPI 1073664678)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073664678 NPI number — SCIODE MEDICAL ASSOCIATES, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SCIODE MEDICAL ASSOCIATES, PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
EASTCHESTER CENTER FOR CANCER CARE
Provider Other Organization Name Type Code:
3
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073664678
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/06/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2330 EASTCHESTER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10469-5930
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-732-4000
Provider Business Mailing Address Fax Number:
718-228-0066

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2330 EASTCHESTER RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10469-5930
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-732-4000
Provider Business Practice Location Address Fax Number:
718-228-0066
Provider Enumeration Date:
01/12/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HOFFMAN
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
Authorized Official Title or Position:
GENERAL PARTNER
Authorized Official Telephone Number:
718-732-4000

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1073664678 . This is a "NPI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1295724391 . This is a "NPI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 02678128 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01324776 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01502809 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1841289931 . This is a "NPI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1518956614 . This is a "NPI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1790881852 . This is a "NPI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01816908 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1225074941 . This is a "NPI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1407817406 . This is a "NPI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1205894268 . This is a "NPI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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