1235257569 NPI number — DRS. BAGUN & RUBIN LLP

Table of content: (NPI 1235257569)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235257569 NPI number — DRS. BAGUN & RUBIN LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DRS. BAGUN & RUBIN LLP
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:
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NPI Number Information

NPI Number:
1235257569
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:
2001 SOUTH RD # 206
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
POUGHKEEPSIE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12601-5978
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-298-1288
Provider Business Mailing Address Fax Number:
845-298-1280

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2001 SOUTH RD # 206
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POUGHKEEPSIE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12601-5978
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-298-1288
Provider Business Practice Location Address Fax Number:
845-298-1280
Provider Enumeration Date:
03/26/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BAGUN
Authorized Official First Name:
ALAN
Authorized Official Middle Name:
Authorized Official Title or Position:
OPTOMETRIST
Authorized Official Telephone Number:
845-298-1288

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  3835 , 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)