1396070256 NPI number — CHINYERE A ROSENSTEEL

Table of content: CHINYERE A ROSENSTEEL (NPI 1396070256)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396070256 NPI number — CHINYERE A ROSENSTEEL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROSENSTEEL
Provider First Name:
CHINYERE
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1396070256
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/08/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
30 TURNQUEST AVE,STAPLEDON GARDENS
Provider Second Line Business Mailing Address:
P.O.BOX N10354
Provider Business Mailing Address City Name:
BAHAMAS
Provider Business Mailing Address State Name:
NASSAU
Provider Business Mailing Address Postal Code:
1242
Provider Business Mailing Address Country Code:
BS
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
503 LAKESIDE CIR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUNRISE
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33326-2136
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-822-6302
Provider Business Practice Location Address Fax Number:
954-358-6446
Provider Enumeration Date:
10/12/2009

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: 251E00000X , with the licence number:  228483 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 253Z00000X , with the licence number: 228483 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251E00000X , with the licence number: 299995404 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 112751100 , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 685527098 . This is a "MEDICAID- MEDWAIVER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 685527096 . This is a "MEDICAID MED-WAIVER" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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