1083984330 NPI number — CROTON GI CARE, PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1083984330 NPI number — CROTON GI CARE, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CROTON GI CARE, PC
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:
JULIE TORMAN MD
Provider Other Organization Name Type Code:
4
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:
1083984330
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/04/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2005 ALBANY POST RD
Provider Second Line Business Mailing Address:
SUITE 15
Provider Business Mailing Address City Name:
CROTON ON HUDSON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10520-1573
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-271-4212
Provider Business Mailing Address Fax Number:
914-271-8319

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2005 ALBANY POST RD
Provider Second Line Business Practice Location Address:
SUITE 15
Provider Business Practice Location Address City Name:
CROTON ON HUDSON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10520-1573
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-271-4212
Provider Business Practice Location Address Fax Number:
914-271-8319
Provider Enumeration Date:
01/04/2012

Additional Information

Authorized Official

Authorized Official Last Name:
TORMAN
Authorized Official First Name:
JULIE
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
914-271-4212

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  194479 , 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: 01634808 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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