1326389826 NPI number — FPA HOSPITAL BASED

Table of content: (NPI 1326389826)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326389826 NPI number — FPA HOSPITAL BASED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FPA HOSPITAL BASED
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:
MOUNT SINAI PATHOLOGY HOSPITALISTS
Provider Other Organization Name Type Code:
3
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:
1326389826
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/16/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 GUSTAVE L LEVY PL
Provider Second Line Business Mailing Address:
ANNENBERG 15TH FLOOR
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10029-6500
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-241-8014
Provider Business Mailing Address Fax Number:
212-426-5129

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 GUSTAVE L LEVY PL
Provider Second Line Business Practice Location Address:
ANNENBERG 15TH FLOOR
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10029-6500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-241-8014
Provider Business Practice Location Address Fax Number:
212-426-5129
Provider Enumeration Date:
03/07/2013

Additional Information

Authorized Official

Authorized Official Last Name:
MACNEILL
Authorized Official First Name:
CRYSTAL
Authorized Official Middle Name:
Authorized Official Title or Position:
VP CBO DIRECTOR
Authorized Official Telephone Number:
212-241-6228

Provider Taxonomy Codes

  • Taxonomy code: 207ZB0001X , with the licence number:  CLIA 33D0653419 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZC0500X , with the licence number: CLIA 33D0653419 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZD0900X , with the licence number: CLIA 33D0653419 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZF0201X , with the licence number: CLIA 33D0653419 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZI0100X , with the licence number: CLIA 33D0653419 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZN0500X , with the licence number: CLIA 33D0653419 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZP0007X , with the licence number: CLIA 33D0653419 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZP0102X , with the licence number: CLIA 33D0653419 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207ZP0213X , with the licence number: CLIA 33D0653419 , 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)





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