1790002228 NPI number — DR. ALKIES LAPAS D.O.

Table of content: DR. ALKIES LAPAS D.O. (NPI 1790002228)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1790002228 NPI number — DR. ALKIES LAPAS D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAPAS
Provider First Name:
ALKIES
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
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:
1790002228
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
85 FRANKLIN AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NUTLEY
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07110-3273
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-798-2828
Provider Business Mailing Address Fax Number:
973-556-1375

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
85 FRANKLIN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NUTLEY
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07110-3273
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-798-2828
Provider Business Practice Location Address Fax Number:
973-556-1375
Provider Enumeration Date:
04/23/2010

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: 2085N0700X , with the licence number:  262553 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085N0700X , with the licence number: 050166 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085N0700X , with the licence number: 25MB08779900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1790002228 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3402770 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 050166 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: A2354331 . This is a "OXFORD HEALTH PLAN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 0630787 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1790002228 . This is a "COMMUNITY HEALTH NETWORK" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 640048 . This is a "WELLCARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 9006795 . This is a "AETNA/US HEALTHCARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P00994884 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".




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