1174670806 NPI number — KING WAI TO M.D.

Table of content: KING WAI TO M.D. (NPI 1174670806)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174670806 NPI number — KING WAI TO M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TO
Provider First Name:
KING
Provider Middle Name:
WAI
Provider Name Prefix Text:
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:
1174670806
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/12/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ONE HOPPIN STREET
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
PROVIDENCE
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
02903-4141
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-831-4592
Provider Business Mailing Address Fax Number:
401-831-4643

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ONE HOPPIN STREET
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
PROVIDENCE
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02903-4141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-831-4592
Provider Business Practice Location Address Fax Number:
401-831-4643
Provider Enumeration Date:
01/04/2007

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: 207W00000X , with the licence number:  7985 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 15679RIH . This is a "HARVARD PILGRIM HEALTHCARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 2503 . This is a "NEIGHBORHOOD HEALTH PLAN OF RI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 20082 . This is a "BCBS OF RI" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 203904 . This is a "BCBS - BLUE CHIP" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 180022235 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( RI ) . This identifiers is of the category "OTHER".
  • Identifier: 9020082 , issued by the state of ( RI ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com