1336389428 NPI number — MRS. ROWENA B. CALVEZ

Table of content: MRS. ROWENA B. CALVEZ (NPI 1336389428)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336389428 NPI number — MRS. ROWENA B. CALVEZ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CALVEZ
Provider First Name:
ROWENA
Provider Middle Name:
B.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BANTING
Provider Other First Name:
RODRIGO
Provider Other Middle Name:
A.
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
RPT
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1336389428
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/02/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9408 214TH PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
QUEENS VILLAGE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11428-1725
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-468-2989
Provider Business Mailing Address Fax Number:
718-468-2989

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9408 214TH PL
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
QUEENS VILLAGE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11428-1725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-468-2989
Provider Business Practice Location Address Fax Number:
718-468-2989
Provider Enumeration Date:
03/02/2009

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: 225100000X , with the licence number:  021177 , 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)