1518285055 NPI number — OBGYN HOSPITALIST MEDICAL SERVICES OF NEW YORK, P.C.

Table of content: (NPI 1518285055)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518285055 NPI number — OBGYN HOSPITALIST MEDICAL SERVICES OF NEW YORK, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OBGYN HOSPITALIST MEDICAL SERVICES OF NEW YORK, P.C.
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:
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:
1518285055
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/10/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
777 LOWNDES HILL RD BLDG 1
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29607-2131
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-967-2289
Provider Business Mailing Address Fax Number:
864-627-9920

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2210 TROY SCHENECTADY RD
Provider Second Line Business Practice Location Address:
BELLEVUE WOMAN'S CARE CENTER
Provider Business Practice Location Address City Name:
NISKAYUNA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12309-4725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-967-2289
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/07/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LAWRENCE
Authorized Official First Name:
CLIFF
Authorized Official Middle Name:
Authorized Official Title or Position:
AUTHORIZED OFFICIAL
Authorized Official Telephone Number:
800-967-2289

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208M00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1801816665 . This is a "NPI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02053932 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".