1336136993 NPI number — DR. MANASH K DASGUPTA M.D.

Table of content: DR. MANASH K DASGUPTA M.D. (NPI 1336136993)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336136993 NPI number — DR. MANASH K DASGUPTA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DASGUPTA
Provider First Name:
MANASH
Provider Middle Name:
K
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1336136993
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/28/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9A CENTRAL PARK AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YONKERS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10705-4746
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-376-3330
Provider Business Mailing Address Fax Number:
914-376-1566

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9A CENTRAL PARK AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YONKERS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10705-4746
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-376-3330
Provider Business Practice Location Address Fax Number:
914-376-1566
Provider Enumeration Date:
09/29/2005

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: 174400000X , with the licence number:  129957 , 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: W38281 . This is a "MEDICARE GROUP PIN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 445112311 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P412198 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1000005074 . This is a "AFFINITY HEALTH PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: CK6794 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00238615 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3300322 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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