1215977046 NPI number — DR. DJAVAD T ARANI MD

Table of content: (NPI 1144513144)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215977046 NPI number — DR. DJAVAD T ARANI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARANI
Provider First Name:
DJAVAD
Provider Middle Name:
T
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1215977046
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/24/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 822
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMBURG
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14075-0822
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-649-0887
Provider Business Mailing Address Fax Number:
716-646-4611

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18 LIMESTONE DR 9
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLIAMSVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14221-8602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-636-0189
Provider Business Practice Location Address Fax Number:
716-636-0190
Provider Enumeration Date:
06/08/2006

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: 207RC0000X , with the licence number:  111123 , 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: 060004770 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00010005602 . This is a "UNIVERA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00677761 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2100439 . This is a "INDEPENDENT HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000510205001 . This is a "WNY BLUE CROSS BLUE SHIEL" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".