1306130984 NPI number — EZ BREATHING

Table of content: (NPI 1306130984)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306130984 NPI number — EZ BREATHING

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
EZ BREATHING
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:
1306130984
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/16/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
235 E 117TH ST
Provider Second Line Business Mailing Address:
STORE 1
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10035-4826
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-338-9551
Provider Business Mailing Address Fax Number:
888-520-2353

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
235 E 117TH ST
Provider Second Line Business Practice Location Address:
STORE 1
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10035-4826
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-338-9551
Provider Business Practice Location Address Fax Number:
888-520-2353
Provider Enumeration Date:
06/01/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
HARGETT
Authorized Official First Name:
PAULA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
718-909-1789

Provider Taxonomy Codes

  • Taxonomy code: 227800000X , with the licence number:  001907-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2278G1100X , with the licence number: 001907-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2278H0200X , with the licence number: 001907-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 332B00000X , with the licence number: 001907-1 , 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)