1952518102 NPI number — PATRICIA ARZIC RPT

Table of content: (NPI 1952518102)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952518102 NPI number — PATRICIA ARZIC RPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PATRICIA ARZIC RPT
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:
HEALTH ONE PHYSICAL THERAPY, PC
Provider Other Organization Name Type Code:
3
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:
1952518102
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
391 E 149TH ST RM 201
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10455-3907
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-401-6888
Provider Business Mailing Address Fax Number:
718-401-8400

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
391 E 149TH ST RM 201
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10455-3907
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-401-6888
Provider Business Practice Location Address Fax Number:
718-401-8400
Provider Enumeration Date:
05/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ARZIC
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
718-505-0707

Provider Taxonomy Codes

  • Taxonomy code: 261QP2000X , with the licence number:  015377-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 261QR0401X , with the licence number: 015377-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 02229445 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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