1306280847 NPI number — MRS. YVETTE D PIPER OTR

Table of content: MRS. YVETTE D PIPER OTR (NPI 1306280847)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306280847 NPI number — MRS. YVETTE D PIPER OTR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PIPER
Provider First Name:
YVETTE
Provider Middle Name:
D
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
OTR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DUQUETTE
Provider Other First Name:
YVETTE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
OTR
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1306280847
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/27/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2050 TILDEN AVE
Provider Second Line Business Mailing Address:
BOX 1000
Provider Business Mailing Address City Name:
NEW HARTFORD
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13413-3613
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-797-3114
Provider Business Mailing Address Fax Number:
315-624-0474

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2050 TILDEN AVE
Provider Second Line Business Practice Location Address:
BOX 1000
Provider Business Practice Location Address City Name:
NEW HARTFORD
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13413-3613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-797-3114
Provider Business Practice Location Address Fax Number:
315-624-0474
Provider Enumeration Date:
04/27/2013

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: 225X00000X , with the licence number:  017593-1 , 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)

  • Identifier: 00313539 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01815443 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".