1477911436 NPI number — WINTHROP FACULTY MEDICAL AFFILIATES UNIVERSITY FACULTY PRACTICE CORP

Table of content: (NPI 1477911436)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477911436 NPI number — WINTHROP FACULTY MEDICAL AFFILIATES UNIVERSITY FACULTY PRACTICE CORP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WINTHROP FACULTY MEDICAL AFFILIATES UNIVERSITY FACULTY PRACTICE CORP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
WINTHROP ONCOLOGY/HEMATOLOGY ASSOCIATES
Provider Other Organization Name Type Code:
3
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:
1477911436
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/30/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 HICKSVILLE RD
Provider Second Line Business Mailing Address:
SUITE 204
Provider Business Mailing Address City Name:
BETHPAGE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11714-3471
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-576-2548
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
200 OLD COUNTRY RD
Provider Second Line Business Practice Location Address:
SUITE 450
Provider Business Practice Location Address City Name:
MINEOLA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11501-4235
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-663-9500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/05/2016

Additional Information

Authorized Official

Authorized Official Last Name:
GRECO
Authorized Official First Name:
JOSEPH
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CO-PRESIDENT
Authorized Official Telephone Number:
516-663-2216

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2024 www.npivalidator.com