1255309175 NPI number — DR. RALPH K MESSO JR. D.O.

Table of content: DR. RALPH K MESSO JR. D.O. (NPI 1255309175)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255309175 NPI number — DR. RALPH K MESSO JR. D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MESSO
Provider First Name:
RALPH
Provider Middle Name:
K
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
D.O.
Provider Gender Code:
M

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:
1255309175
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/05/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4143 RICHMOND AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STATEN ISLAND
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10312-5637
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-966-5556
Provider Business Mailing Address Fax Number:
718-966-7483

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4143 RICHMOND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STATEN ISLAND
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10312-5637
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-966-5556
Provider Business Practice Location Address Fax Number:
718-966-7483
Provider Enumeration Date:
03/08/2006

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: 207R00000X , with the licence number:  184376 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208000000X , with the licence number: 184376 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0401475 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: NYM184376 . This is a "OXFORD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: OP235 . This is a "OXFORD HEALTH PLANS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 13418106800 . This is a "TOUCHSTONE HEALTH PSO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01460282 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4566381 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: HEALTHNET . This is a "1P0525" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 040184376NY02 . This is a "ANTHEM HEALTH NETWORK" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: MR4376 . This is a "ATLANTIS HEALTH PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 184376 . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0451877 . This is a "AETNA/USHC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 162158 . This is a "ELDERPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1P0065 . This is a "TOUCHSTONE HEALTH PARTNER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 129AS1 . This is a "EMPIRE BC/BS" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 17G412 . This is a "EMPIRE BC/BS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2698319 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: Y044934 . This is a "CHAMPUS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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