1063654994 NPI number — DR. VALERIE MICHELLE ORAM M.D.

Table of content: CHRISTOPHER AGATEP NP-C (NPI 1497347173)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063654994 NPI number — DR. VALERIE MICHELLE ORAM M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ORAM
Provider First Name:
VALERIE
Provider Middle Name:
MICHELLE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

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:
1063654994
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/23/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
317 E 34TH ST FL 5
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10016-4911
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-981-7258
Provider Business Mailing Address Fax Number:
212-209-3218

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
317 E 34TH ST FL 5
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:
10016-4911
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-981-7258
Provider Business Practice Location Address Fax Number:
212-209-3218
Provider Enumeration Date:
03/24/2009

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: 207RE0101X , with the licence number:  240824 , 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: A400015635 . This is a "MEDICARE PTAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: A400040610 . This is a "MEDICARE PTAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00506318 . This is a "MEDICAID GROUP NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 03135802 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: P00788628 . This is a "RR MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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