1235326000 NPI number — EGER PSYCHOLOGICAL SERVICES PC

Table of content: JOSEPH STANDING BEAR CPC (NPI 1356122857)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1235326000 NPI number — EGER PSYCHOLOGICAL SERVICES PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EGER PSYCHOLOGICAL SERVICES PC
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:
1235326000
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/26/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
90 BRYANT AVE
Provider Second Line Business Mailing Address:
B-TC
Provider Business Mailing Address City Name:
WHITE PLAINS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10605-1952
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-946-0142
Provider Business Mailing Address Fax Number:
914-288-8007

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
90 BRYANT AVE
Provider Second Line Business Practice Location Address:
B-TC
Provider Business Practice Location Address City Name:
WHITE PLAINS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10605-1952
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-946-0142
Provider Business Practice Location Address Fax Number:
914-288-8007
Provider Enumeration Date:
09/26/2007

Additional Information

Authorized Official

Authorized Official Last Name:
EGER
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
914-946-0142

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X , with the licence number:  007001-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com