1700887924 NPI number — DR. NICOLAE S CARAIANI M.D.

Table of content: DR. NICOLAE S CARAIANI M.D. (NPI 1700887924)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700887924 NPI number — DR. NICOLAE S CARAIANI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARAIANI
Provider First Name:
NICOLAE
Provider Middle Name:
S
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1700887924
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2500 ROUTE 347
Provider Second Line Business Mailing Address:
BUILDING 14A
Provider Business Mailing Address City Name:
STONY BROOK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11790-2554
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-689-7800
Provider Business Mailing Address Fax Number:
631-689-3016

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2500 ROUTE 347
Provider Second Line Business Practice Location Address:
BUILDING 14A
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11790-2554
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-689-7800
Provider Business Practice Location Address Fax Number:
631-689-3016
Provider Enumeration Date:
08/10/2005

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: 207RN0300X , with the licence number:  210688 , 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: 807271 . This is a "EMPIRE BLUECROSS BLUESHIE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 390006005 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 88014 . This is a "VYTRA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P1041212 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01861210 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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