1366538498 NPI number — DR. FE AGTARAP NAVARRETE MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366538498 NPI number — DR. FE AGTARAP NAVARRETE MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

NAVARRETE

Provider First Name:

FE

Provider Middle Name:

AGTARAP

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

F

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:

1366538498

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

07/08/2007

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

248 03 139TH AVE

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

ROSEDALE

Provider Business Mailing Address State Name:

NY

Provider Business Mailing Address Postal Code:

11422

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

718-525-7706

Provider Business Mailing Address Fax Number:

718-525-7097

Provider First Line Business Practice Location Address:

48 MELROSE ST

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

BROOKLYN

Provider Business Practice Location Address State Name:

NY

Provider Business Practice Location Address Postal Code:

11206

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

718-919-0005

Provider Business Practice Location Address Fax Number:

718-525-7097

Provider Enumeration Date:

10/05/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 208000000X , with the licence number:  153486 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 040426028384 . This is a "FIDELIS" identifier . This identifiers is of the category "OTHER".
• Identifier: 010153486NY . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
• Identifier: 00754921 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
• Identifier: 261007 . This is a "UNITED HC" identifier . This identifiers is of the category "OTHER".
• Identifier: 100015199 . This is a "AFFINITY" identifier . This identifiers is of the category "OTHER".
• Identifier: 153486E16 . This is a "HEALTH FIRST" identifier . This identifiers is of the category "OTHER".
• Identifier: 1C1948 . This is a "HEALTH NET" identifier . This identifiers is of the category "OTHER".
• Identifier: 000025701 . This is a "AMERI CHOICE" identifier . This identifiers is of the category "OTHER".
• Identifier: P2046087 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
• Identifier: P61104440 . This is a "MULTI PLAN" identifier . This identifiers is of the category "OTHER".
• Identifier: 08419 . This is a "HIP" identifier . This identifiers is of the category "OTHER".
• Identifier: 26P9781 . This is a "NY PRESBYTERIAN HEALTH PL" identifier . This identifiers is of the category "OTHER".
• Identifier: 1534860199001 . This is a "NEIGHBORHOOD HEALTH PROV" identifier . This identifiers is of the category "OTHER".