1871696401 NPI number — CHRISTINE A. RODGERS RPA-C

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871696401 NPI number — CHRISTINE A. RODGERS RPA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RODGERS
Provider First Name:
CHRISTINE
Provider Middle Name:
A.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RPA-C
Provider Gender Code:
F

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:
1871696401
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 505
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH CHILI
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14514-0505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-594-5995
Provider Business Mailing Address Fax Number:
585-594-5425

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4201 BUFFALO RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH CHILI
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14514-1256
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-594-5995
Provider Business Practice Location Address Fax Number:
585-594-5425
Provider Enumeration Date:
09/07/2006

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: 363A00000X , with the licence number:  005478 , 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: 00570414001 . This is a "COMMUNITY BL ADV" identifier . This identifiers is of the category "OTHER".
  • Identifier: 040426004288 . This is a "FIDELIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00570414001 . This is a "COMMUNITY BLUE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00570414001 . This is a "FAMILY HEALTH PLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7387280 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9512290 . This is a "IHA CUSTOM COVERAGE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00570414001 . This is a "HEALTHY NY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7387280 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9512290 . This is a "IHA ENCOMPASS 65" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00570414001 . This is a "BCBCS OF WNY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7387280 . This is a "AETNA PPO POS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9512290 . This is a "IHA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00570414001 . This is a "HMO 100" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00570414001 . This is a "COMMUNITY CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00570414001 . This is a "ASO PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00570414001 . This is a "CHILD HEALTH PLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00570414001 . This is a "SENIOR BLUE" identifier . This identifiers is of the category "OTHER".




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