1336210467 NPI number — REGINA WINOCUR M.A.,R.D.,C.D.E

Table of content: REGINA WINOCUR M.A.,R.D.,C.D.E (NPI 1336210467)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336210467 NPI number — REGINA WINOCUR M.A.,R.D.,C.D.E

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WINOCUR
Provider First Name:
REGINA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.A.,R.D.,C.D.E
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:
1336210467
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23 GROVE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLD SPRING HARBOR
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11724-1821
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-374-6345
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
29 BARSTOW RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREAT NECK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11021-2209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-374-6345
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/12/2006

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: 133V00000X , with the licence number:  003616-1 , 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: 03P751 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7986383003 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P2066625 . This is a "OXFORD HEALTH PLANS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 270003616NY01 . This is a "ANTHEM" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 8000213 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2125738 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 127512 . This is a "VYTRA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1938133 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: AZ0089-2 . This is a "MDNY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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