1245303346 NPI number — SHARON D DEANS M.D. FACOG

Table of content: SHARON D DEANS M.D. FACOG (NPI 1245303346)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245303346 NPI number — SHARON D DEANS M.D. FACOG

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEANS
Provider First Name:
SHARON
Provider Middle Name:
D
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D. FACOG
Provider Gender Code:
F

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:
1245303346
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/22/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
444 COMMUNITY DR
Provider Second Line Business Mailing Address:
SUITE 105
Provider Business Mailing Address City Name:
MANHASSET
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11030-3820
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-365-3666
Provider Business Mailing Address Fax Number:
516-365-3799

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
444 COMMUNITY DR
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
MANHASSET
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11030-3820
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-365-3666
Provider Business Practice Location Address Fax Number:
516-365-3799
Provider Enumeration Date:
11/16/2006

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: 174400000X , with the licence number:  BD2588070 , 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: 5C8759 . This is a "HEALTH NET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0201563 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 189139 . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: E71545 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 189139 . This is a "VYTRA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 189139-C27 . This is a "HEALTH FIRST" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 499252 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P699451 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1258178 . This is a "UNITED" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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