1689682437 NPI number — ERROLL I BYER

Table of content: ERROLL I BYER (NPI 1689682437)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689682437 NPI number — ERROLL I BYER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BYER
Provider First Name:
ERROLL
Provider Middle Name:
I
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
M

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:
1689682437
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/13/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
650 FULTON ST
Provider Second Line Business Mailing Address:
ADMINISTRATION
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11217
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-596-9800
Provider Business Mailing Address Fax Number:
718-596-9889

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
650 FULTON 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:
11217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-596-9800
Provider Business Practice Location Address Fax Number:
718-596-9889
Provider Enumeration Date:
08/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  217043 , 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: 112467268-BY01 . This is a "CAREPLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 217043 . This is a "HIP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 40426029652 . This is a "FIDELIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: HMO-2645172 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 116710101 . This is a "HEALTHPLUS/CHILD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 87671PPO-0297354 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: P2973565 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 240647 . This is a "WELLCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: SP10964 . This is a "CENTER CARE/CHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0100079-02 . This is a "AMERICHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 16P0393 . This is a "NYPRESCHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 217043B21 . This is a "HEALTHFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: PPO 7007192 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".




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