1043269269 NPI number — ROBERT EDWARD KAPLAN MD

Table of content: JULIA ROUSSOS PA-C (NPI 1104452176)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043269269 NPI number — ROBERT EDWARD KAPLAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAPLAN
Provider First Name:
ROBERT
Provider Middle Name:
EDWARD
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1043269269
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/14/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
237 LINWOOD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BUFFALO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14209-2009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-932-6423
Provider Business Mailing Address Fax Number:
716-932-6007

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
237 LINWOOD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14209-2009
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-932-6423
Provider Business Practice Location Address Fax Number:
716-932-6007
Provider Enumeration Date:
05/06/2006

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: 208000000X , with the licence number:  1577782 , 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: 01209067 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000510282004 . This is a "BC/BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 040426000163 . This is a "FIDELIS-AUDUBON OFFICE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 040426000162 . This is a "FIDELIS-LINWOOD AVE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00010087602 . This is a "UNIVERA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000510282001 . This is a "BC/BS OF WNY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 050303000029 . This is a "FIDELIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 080407000096 . This is a "FIDELIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1201997 . This is a "IHA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00010087601 . This is a "UNIVERA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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