1184772592 NPI number — NEW YORK RADIOLOGY ASSOCAITES

Table of content: (NPI 1184772592)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184772592 NPI number — NEW YORK RADIOLOGY ASSOCAITES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW YORK RADIOLOGY ASSOCAITES
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:
NEW YORK EYE AND EAR INFIRMARY, DEPT OF RADIOLOGY
Provider Other Organization Name Type Code:
3
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:
1184772592
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/28/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 95000-2429
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19195-2429
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-830-3122
Provider Business Mailing Address Fax Number:
201-200-0838

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
310 E 14TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10003-4201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-590-2930
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ABIRI
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
CHAIRMAN
Authorized Official Telephone Number:
201-830-3122

Provider Taxonomy Codes

  • Taxonomy code: 2085N0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085N0904X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085P0229X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0202X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2085R0205X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 01538852 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com