1013188986 NPI number — ARTHUR R DOVE MD PC

Table of content: (NPI 1013188986)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1013188986 NPI number — ARTHUR R DOVE MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ARTHUR R DOVE MD PC
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:
1013188986
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/01/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25 ODONNELL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTWOOD
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07675-2728
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-876-8655
Provider Business Mailing Address Fax Number:
212-876-4545

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
85 W 118TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10026-1903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-876-8655
Provider Business Practice Location Address Fax Number:
212-876-4545
Provider Enumeration Date:
03/18/2008

Additional Information

Authorized Official

Authorized Official Last Name:
DOVE
Authorized Official First Name:
ARTHUR
Authorized Official Middle Name:
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
212-876-8655

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  193836 , 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: 163691 . This is a "ELDERPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 75190EK811 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1000000108 . This is a "AFFINITY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 211911 . This is a "WELLCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 65S271 . This is a "EMPIRE BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2594026 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P2053741 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01675290 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 193836A85 . This is a "HEALTHFIRST" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5588651 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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