1265777890 NPI number — MISS BABETTE DE LEON SANTOS NURSE PRACTITIONER

Table of content: MISS BABETTE DE LEON SANTOS NURSE PRACTITIONER (NPI 1265777890)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265777890 NPI number — MISS BABETTE DE LEON SANTOS NURSE PRACTITIONER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SANTOS
Provider First Name:
BABETTE
Provider Middle Name:
DE LEON
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
NURSE PRACTITIONER
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:
1265777890
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/26/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ONE GUSTAVE L. LEVY PLACE
Provider Second Line Business Mailing Address:
MOUNT SINAI MEDICAL CENTER
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10029
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-241-6500
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19 E 98TH ST FL 1
Provider Second Line Business Practice Location Address:
MOUNT SINAI MEDICAL CENTER
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10029-6501
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-241-7911
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/07/2012

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: 363LA2100X , with the licence number:  430658 , 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)