1659597573 NPI number — P KRAWITZ MD P.C.

Table of content: (NPI 1659597573)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659597573 NPI number — P KRAWITZ MD P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
P KRAWITZ MD 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:
GERALD BLUMENTHAL, M.D., CHARLES I. BLOOMGARDEN M.D., P.C. AND BERNARD
Provider Other Organization Name Type Code:
4
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:
1659597573
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/25/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
755 PARK AVENUE
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
HUNTINGTON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11743-3972
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
361-223-0400
Provider Business Mailing Address Fax Number:
631-421-2689

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
755 PARK AVENUE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11743-3972
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-223-0400
Provider Business Practice Location Address Fax Number:
631-421-2689
Provider Enumeration Date:
04/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
KRAWITZ
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
631-223-0400

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  TUV005551 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 005551 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: 086064 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: 166763-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207W00000X , with the licence number: 099017 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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