1245380997 NPI number — MRS. JOSIE A CARUANA P.A.

Table of content: MRS. JOSIE A CARUANA P.A. (NPI 1245380997)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245380997 NPI number — MRS. JOSIE A CARUANA P.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARUANA
Provider First Name:
JOSIE
Provider Middle Name:
A
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
P.A.
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:
1245380997
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/06/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
565 ABBOTT ROAD
Provider Second Line Business Mailing Address:
MERCY HOSPITAL DEPT OF MEDICINE
Provider Business Mailing Address City Name:
BUFFALO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-826-7000
Provider Business Mailing Address Fax Number:
716-828-3472

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
310 STERLING DRIVE
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
ORCHARD PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14127-1569
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-675-7730
Provider Business Practice Location Address Fax Number:
716-675-7735
Provider Enumeration Date:
01/12/2007

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: 363AS0400X , with the licence number:  006973 , 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: 01994687 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com