1174819403 NPI number — MS. PAULINE E SAINTU B.A.

Table of content: MS. PAULINE E SAINTU B.A. (NPI 1174819403)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174819403 NPI number — MS. PAULINE E SAINTU B.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAINTU
Provider First Name:
PAULINE
Provider Middle Name:
E
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
B.A.
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:
1174819403
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/24/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1138 WELLING CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASTORIA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11102-4023
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
347-558-2278
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11515 SUTPHIN BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JAMAICA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11434-1020
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-659-4000
Provider Business Practice Location Address Fax Number:
718-659-1405
Provider Enumeration Date:
06/24/2011

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1235288333 . This is a "SOUTH JAMAICA CLINIC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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