1184706442 NPI number — SCHENECTADY OTOLARYNGOLOGY HEAD & NECK SURGERY LLP

Table of content: (NPI 1184706442)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184706442 NPI number — SCHENECTADY OTOLARYNGOLOGY HEAD & NECK SURGERY LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SCHENECTADY OTOLARYNGOLOGY HEAD & NECK SURGERY LLP
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1184706442
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/05/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
700 MCCLELLAN ST
Provider Second Line Business Mailing Address:
SUITE 700
Provider Business Mailing Address City Name:
SCHENECTADY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12304-1019
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-347-2950
Provider Business Mailing Address Fax Number:
518-347-2197

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
700 MCCLELLAN ST
Provider Second Line Business Practice Location Address:
SUITE 700
Provider Business Practice Location Address City Name:
SCHENECTADY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12304-1019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-347-2950
Provider Business Practice Location Address Fax Number:
518-347-2197
Provider Enumeration Date:
10/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CHAPADOS
Authorized Official First Name:
GILLES
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
518-347-2950

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: B82899 . This is a "GILLES CHAPADOS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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