1275512758 NPI number — DR. MICHAEL LUVIN MD

Table of content: DR. MICHAEL LUVIN MD (NPI 1275512758)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275512758 NPI number — DR. MICHAEL LUVIN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LUVIN
Provider First Name:
MICHAEL
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1275512758
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
77 N CENTRE AVE
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
ROCKVILLE CENTRE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11570-3923
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-764-7246
Provider Business Mailing Address Fax Number:
516-678-3525

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
77 N CENTRE AVE
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
ROCKVILLE CENTRE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11570-3923
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-764-7246
Provider Business Practice Location Address Fax Number:
516-678-3525
Provider Enumeration Date:
01/12/2006

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: 207L00000X , with the licence number:  165779-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207LP2900X , with the licence number: 165779-1 , 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: 4228750 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 150174 . This is a "VYTRA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 97B341 . This is a "BCBS & SENIOR PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: CM0035 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P2084603 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8799820 . This is a "GHI PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 87249 . This is a "GHI HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01163991 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7772066 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".




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