1033272257 NPI number — KIRIT DHARIA MD,PC

Table of content: (NPI 1033272257)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033272257 NPI number — KIRIT DHARIA MD,PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KIRIT DHARIA 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:
NEWTOWN MEDICAL
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:
1033272257
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/15/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3289 46TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASTORIA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11103-1911
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-728-7550
Provider Business Mailing Address Fax Number:
718-728-7550

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3289 46TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ASTORIA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11103-1911
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-728-7550
Provider Business Practice Location Address Fax Number:
718-728-7550
Provider Enumeration Date:
12/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
DHARIA
Authorized Official First Name:
KIRIT
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
718-728-7550

Provider Taxonomy Codes

  • Taxonomy code: 208600000X , with the licence number:  115592 , 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: 02N0092 . This is a "NEIGHBORHOOD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 24968P . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01-00087 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: DP120 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1000038373 . This is a "AFFINITY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 169245 . This is a "ELDERPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 59F351 . This is a "BCBS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00115592 . This is a "METROPLUS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00213552 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10211211 . This is a "AMERIGROUPCORP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 115592-A48 . This is a "HEALTH FIRST" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 62207303 . This is a "MULTIPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: KIR36DEO332 . This is a "HORIZON" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4234909 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00000009424 . This is a "GHI PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0085283 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0712096-012 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 370012242 . This is a "HEALTH PLUS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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