1205089281 NPI number — MRS. MARIA FELISA ORDAS ILAGAN P.T.

Table of content: MRS. MARIA FELISA ORDAS ILAGAN P.T. (NPI 1205089281)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205089281 NPI number — MRS. MARIA FELISA ORDAS ILAGAN P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ILAGAN
Provider First Name:
MARIA FELISA
Provider Middle Name:
ORDAS
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ORDAS
Provider Other First Name:
MARIA FELISA
Provider Other Middle Name:
SIOSON
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
P.T.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1205089281
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4487 3RD AVE
Provider Second Line Business Mailing Address:
7TH FLOOR
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10457-1526
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-960-9000
Provider Business Mailing Address Fax Number:
718-960-9397

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4487 3RD AVE
Provider Second Line Business Practice Location Address:
7TH FLOOR
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10457-1526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-960-9000
Provider Business Practice Location Address Fax Number:
718-960-9397
Provider Enumeration Date:
11/04/2008

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: 225100000X , with the licence number:  026091 , 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)