1821301375 NPI number — SMART HEALTH MEDICAL, P.C.

Table of content: DR. SCOTT H LANCASTER M.D. (NPI 1386647329)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821301375 NPI number — SMART HEALTH MEDICAL, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SMART HEALTH MEDICAL, 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:
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:
1821301375
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/26/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
160 E 84TH ST
Provider Second Line Business Mailing Address:
10L
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10028-2008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-258-2574
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
83-45 DONGAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
QUEENS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11373-3755
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-258-2574
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/26/2010

Additional Information

Authorized Official

Authorized Official Last Name:
QUACH
Authorized Official First Name:
VI
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
646-258-2574

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  211187 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 246652 , 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)





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