1154588804 NPI number — DR. PAUL FENYVES M.D.

Table of content: DR. PAUL FENYVES M.D. (NPI 1154588804)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154588804 NPI number — DR. PAUL FENYVES M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FENYVES
Provider First Name:
PAUL
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1154588804
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/31/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
215 E 85TH ST
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:
10028-3108
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-962-7300
Provider Business Mailing Address Fax Number:
214-941-1047

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ATRIA
Provider Second Line Business Practice Location Address:
36 E 57TH STREET 5TH FL
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-600-2000
Provider Business Practice Location Address Fax Number:
212-590-0857
Provider Enumeration Date:
05/20/2008

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: 207R00000X , with the licence number:  N2497 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 246846 , 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: 207962601 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8X0096 . This is a "BC/BS" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".