1083701916 NPI number — DR. ANJALI ANKOLEKAR MD

Table of content: DR. ANJALI ANKOLEKAR MD (NPI 1083701916)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083701916 NPI number — DR. ANJALI ANKOLEKAR MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANKOLEKAR
Provider First Name:
ANJALI
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
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:
1083701916
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
777 N BROADWAY
Provider Second Line Business Mailing Address:
SUITE 308
Provider Business Mailing Address City Name:
SLEEPY HOLLOW
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10591-1000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-631-0908
Provider Business Mailing Address Fax Number:
914-366-0054

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
777 N BROADWAY
Provider Second Line Business Practice Location Address:
SUITE 308
Provider Business Practice Location Address City Name:
SLEEPY HOLLOW
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10591-1000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-631-0908
Provider Business Practice Location Address Fax Number:
914-366-0054
Provider Enumeration Date:
10/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  153917 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 327247 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 49607 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00848504 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: OD2120 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: WP476 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 508C71 . This is a "EMPIRE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000703749-005 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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