1104956754 NPI number — UNITED STATES CATHOLIC CONFERENCE ST. CABRINI HOME, INC.

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 1104956754 NPI number — UNITED STATES CATHOLIC CONFERENCE ST. CABRINI HOME, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNITED STATES CATHOLIC CONFERENCE ST. CABRINI HOME, INC.
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:
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:
1104956754
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CABRINI HOME, INC.
Provider Second Line Business Mailing Address:
2085 RT 9W
Provider Business Mailing Address City Name:
WEST PARK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12493
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-384-6500
Provider Business Mailing Address Fax Number:
845-384-6001

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CABRINI HOME, INC.
Provider Second Line Business Practice Location Address:
2085 RT 9W
Provider Business Practice Location Address City Name:
WEST PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12493
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-384-6500
Provider Business Practice Location Address Fax Number:
845-384-6001
Provider Enumeration Date:
03/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BROGNANO
Authorized Official First Name:
LIA
Authorized Official Middle Name:
Authorized Official Title or Position:
ACCTS RECEIVABLES
Authorized Official Telephone Number:
845-383-3913

Provider Taxonomy Codes

  • Taxonomy code: 261Q00000X , with the licence number:  012789 , 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: 07317 . This is a "NYSOASAS PRU NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 081111324 . This is a "CERTIFICATE NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 41990 . This is a "PROGRAM PROVIDER NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 02324550 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 012789 . This is a "LICENSE NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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