1902838816 NPI number — AZAD K ANAND, M.D., P.C. M.D.

Table of content: AZAD K ANAND, M.D., P.C. M.D. (NPI 1902838816)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902838816 NPI number — AZAD K ANAND, M.D., P.C. M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ANAND, M.D., P.C.
Provider First Name:
AZAD
Provider Middle Name:
K
Provider Name Prefix Text:
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:
1902838816
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 63
Provider Second Line Business Mailing Address:
LONG ISLAND DIAGNOSTIC IMAGING
Provider Business Mailing Address City Name:
SYOSSET
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11791-0063
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-689-7300
Provider Business Mailing Address Fax Number:
631-689-7321

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23 TECHNOLOGY DR
Provider Second Line Business Practice Location Address:
LONG ISLAND DIAGNSOTIC IMAGING
Provider Business Practice Location Address City Name:
EAST SETAUKET
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11733-4075
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-689-7300
Provider Business Practice Location Address Fax Number:
631-689-7321
Provider Enumeration Date:
07/07/2006

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: 2085R0202X , with the licence number:  138079 , 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: 112983328 . This is a "TAX ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1194851931 . This is a "SITE NPI NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1548396203 . This is a "SITE NPI NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00571857 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1114189735 . This is a "GROUP NPI NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1689700403 . This is a "SITE NPI NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 112797720 . This is a "TAX ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1982730784 . This is a "SITE NPI NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 113119124 . This is a "TAX ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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