1164408365 NPI number — DR. JAMES JOSEPH DOYLE III MD

Table of content: MRS. MAUREEN MIKA EBERLY (NPI 1205959848)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164408365 NPI number — DR. JAMES JOSEPH DOYLE III MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DOYLE
Provider First Name:
JAMES
Provider Middle Name:
JOSEPH
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
III
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:
1164408365
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/28/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2700 WESTCHESTER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PURCHASE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10577-2547
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-607-5730
Provider Business Mailing Address Fax Number:
914-457-1195

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 THEALL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
RYE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10580-1404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-681-3146
Provider Business Practice Location Address Fax Number:
914-682-6403
Provider Enumeration Date:
12/20/2005

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: 207RP1001X , with the licence number:  213236 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RP1001X , with the licence number: 038983 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 133884168 . This is a "HORIZON HEALTHCARE OF NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2180273 . This is a "AETNA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 50492 . This is a "GHI HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133884168 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 21R221 . This is a "BLUE CROSS PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133884168 . This is a "POMCO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 213236 . This is a "CONNECTICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 110219624 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133884168 . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133884168 . This is a "PHCS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133884168 . This is a "EMPIRE STATE PLAN (NYS)" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133884168 . This is a "MULTIPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3C1072 . This is a "HEALTH NET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P1850228 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0101967-010 . This is a "CIGNA (PCP)" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2999488 . This is a "GHI PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 02023458 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7065006 . This is a "AETNA NON HMO" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".




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