1538332978 NPI number — DR EMILIO BIAGIOTTI PHYSICIAN PC

Table of content: (NPI 1538332978)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538332978 NPI number — DR EMILIO BIAGIOTTI PHYSICIAN PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR EMILIO BIAGIOTTI PHYSICIAN PC
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:
1538332978
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/07/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4386
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STAMFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06907-0386
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-863-7925
Provider Business Mailing Address Fax Number:
718-863-8208

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3101 E TREMONT AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10461-5705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-863-7925
Provider Business Practice Location Address Fax Number:
718-863-8208
Provider Enumeration Date:
04/07/2008

Additional Information

Authorized Official

Authorized Official Last Name:
BIAGIOTTI
Authorized Official First Name:
EMILIO
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
718-863-7925

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  186469 , 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)

  • Identifier: 186469 . This is a "LICENSE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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