1114921848 NPI number — DR. IRA NEIL BACHMAN MD,FACOG

Table of content: (NPI 1134427578)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1114921848 NPI number — DR. IRA NEIL BACHMAN MD,FACOG

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BACHMAN
Provider First Name:
IRA
Provider Middle Name:
NEIL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD,FACOG
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:
1114921848
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
660 CENTRAL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CEDARHURST
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11516-2303
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-374-1777
Provider Business Mailing Address Fax Number:
516-295-9245

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
660 CENTRAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CEDARHURST
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11516-2303
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-374-1777
Provider Business Practice Location Address Fax Number:
516-295-9245
Provider Enumeration Date:
06/10/2005

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: 174400000X , with the licence number:  192114 , 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: 5111079 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 9335843 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: OC6527 . This is a "PHYSICIANS HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: QU49278 . This is a "MDNY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0202045 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 20889 . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P00089322 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 06230I . This is a "GUEENS MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 60340 . This is a "VYTRA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 553328 . This is a "HEALTHCARE PARTNERS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 700890 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: AP985 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1851445 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 529801 . This is a "USHC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 200151 . This is a "BLUE/CROSS BLUE/SHEILD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: NS0001694 . This is a "SELECT" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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