1285602433 NPI number — DR. ESTI G GUMPERTZ M.D.

Table of content: DR. ESTI G GUMPERTZ M.D. (NPI 1285602433)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285602433 NPI number — DR. ESTI G GUMPERTZ M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUMPERTZ
Provider First Name:
ESTI
Provider Middle Name:
G
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

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:
1285602433
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6801 MAYFIELD RD
Provider Second Line Business Mailing Address:
SUITE 244
Provider Business Mailing Address City Name:
MAYFIELD HTS
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44124-2270
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
440-646-1600
Provider Business Mailing Address Fax Number:
440-646-1505

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6801 MAYFIELD RD
Provider Second Line Business Practice Location Address:
SUITE 244
Provider Business Practice Location Address City Name:
MAYFIELD HTS
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44124-2270
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
440-646-1600
Provider Business Practice Location Address Fax Number:
440-646-1505
Provider Enumeration Date:
03/12/2006

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: 207NS0135X , with the licence number:  35052867 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000133524 . This is a "BLUE CROSS / BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0631034 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 341537793 . This is a "PROFESSIONAL CLAIMS MANAGEMENT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 341537793 . This is a "SECURE HORIZONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 341537793 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3415377930001 . This is a "EXPACARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3415377930001 . This is a "UNITED AMERICAN INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0631034 . This is a "PEOPLE'S HEALTH PLAN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 102510 . This is a "KAISER PERMANENTE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 341537793 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3415377930001 . This is a "GOLDEN RULE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3415377930001 . This is a "PRINCIPAL LIFE INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: R52867 . This is a "SUMACARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 341537793 . This is a "MAIL HANDLERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3415377930001 . This is a "EMERALD HEALTH NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3415377930001 . This is a "NIPPON LIFE INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 07000311 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 3415377930001 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3415377930001 . This is a "HEALTHLINK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3415377930001 . This is a "OHIO CONFERENCE OF PLASTERERS" identifier . This identifiers is of the category "OTHER".




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