1225016140 NPI number — LABORATORIO DE PATOLOGIA DR NOY

Table of content: (NPI 1225016140)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225016140 NPI number — LABORATORIO DE PATOLOGIA DR NOY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LABORATORIO DE PATOLOGIA DR NOY
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:
1225016140
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 362842
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00936-2842
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-751-1312
Provider Business Mailing Address Fax Number:
787-751-5158

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
239 ARTERIAL HOSTOS
Provider Second Line Business Practice Location Address:
SUITE 1-A SOTANO CAPITAL CENTER TORREL
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-751-1312
Provider Business Practice Location Address Fax Number:
787-756-0575
Provider Enumeration Date:
01/03/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NOY
Authorized Official First Name:
MIGUEL
Authorized Official Middle Name:
A
Authorized Official Title or Position:
ADMINISTRADOR
Authorized Official Telephone Number:
787-751-1312

Provider Taxonomy Codes

  • Taxonomy code: 207ZP0101X , with the licence number:  264B , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2100371 . This is a "ACCA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 611101 . This is a "HUMANA GOLD CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2659 . This is a "INTERNATIONAL MEDICAL CAR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 069915 . This is a "LA CRUZ AZUL DE PR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 800073 . This is a "MMM HEALTHCARE INC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9360108 . This is a "HUMANA INSURANCE COMPANY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0940699 . This is a "FONDO DEL SEGURO DEL ESTA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 22685 . This is a "ASOCIACION DE MAESTROS DE" identifier . This identifiers is of the category "OTHER".




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