1124119870 NPI number — DRS. ROBERT H ADLER & THOMAS D'AUGUSTA D.D.S.

Table of content: (NPI 1124119870)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1124119870 NPI number — DRS. ROBERT H ADLER & THOMAS D'AUGUSTA D.D.S.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRS. ROBERT H ADLER & THOMAS D'AUGUSTA D.D.S.
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:
1124119870
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4 DRUMGOOLE RD E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STATEN ISLAND
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10312-2008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-356-7878
Provider Business Mailing Address Fax Number:
718-356-7943

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4 DRUMGOOLE RD E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STATEN ISLAND
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10312-2008
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-356-7878
Provider Business Practice Location Address Fax Number:
718-356-7943
Provider Enumeration Date:
09/27/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MOLININI
Authorized Official First Name:
STEPHANIE
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
718-356-7878

Provider Taxonomy Codes

  • Taxonomy code: 1223G0001X , with the licence number:  26709 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1223G0001X , with the licence number: 37859 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223G0001X , with the licence number: 50463 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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