1003527870 NPI number — BOUNTAH ONG OSPINA LAWSON REGISTERED NURSE

Table of content: BOUNTAH ONG OSPINA LAWSON REGISTERED NURSE (NPI 1003527870)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003527870 NPI number — BOUNTAH ONG OSPINA LAWSON REGISTERED NURSE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OSPINA LAWSON
Provider First Name:
BOUNTAH
Provider Middle Name:
ONG
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
REGISTERED NURSE
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LAWSON
Provider Other First Name:
BOUNTAH
Provider Other Middle Name:
ONG
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1003527870
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
227 EAST 41ST STREET
Provider Second Line Business Mailing Address:
8TH FLOOR
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10017
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
227 E 41ST ST
Provider Second Line Business Practice Location Address:
8TH FLOOR
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-273-6272
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/12/2022

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: 163WP2201X , with the licence number:  796187 , 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: 796187 . This is a "RN LICENSE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com