1225134851 NPI number — CARITAS EMERGENCY MEDICAL SERVICES, PC

Table of content: (NPI 1225134851)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225134851 NPI number — CARITAS EMERGENCY MEDICAL SERVICES, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARITAS EMERGENCY MEDICAL SERVICES, 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:
CARITAS MIH EMERG MED SRV, PC
Provider Other Organization Name Type Code:
5
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:
1225134851
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:
158 W 27TH ST
Provider Second Line Business Mailing Address:
11TH FLOOR
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10001-6216
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-563-2497
Provider Business Mailing Address Fax Number:
212-563-0605

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15211 89TH AVE
Provider Second Line Business Practice Location Address:
EMERGENCY ROOM
Provider Business Practice Location Address City Name:
JAMAICA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11432-3730
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-563-2497
Provider Business Practice Location Address Fax Number:
212-563-0605
Provider Enumeration Date:
09/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FARRAT
Authorized Official First Name:
JORGE
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
212-563-2497

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207PP0204X ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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





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