1396087888 NPI number — CANCER AND BLOOD MEDICAL SERVICES OF NEW YORK, PC

Table of content: (NPI 1396087888)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396087888 NPI number — CANCER AND BLOOD MEDICAL SERVICES OF NEW YORK, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CANCER AND BLOOD MEDICAL SERVICES OF NEW YORK, PC
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:
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:
1396087888
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/03/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 LONGVIEW AVE
Provider Second Line Business Mailing Address:
3RD FLOOR
Provider Business Mailing Address City Name:
WHITE PLAINS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10601-5000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-684-2779
Provider Business Mailing Address Fax Number:
914-684-2688

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 LONGVIEW AVE FL 3
Provider Second Line Business Practice Location Address:
WHITE PLAINS HOSPITAL CENTER FOR CANCER CARE
Provider Business Practice Location Address City Name:
WHITE PLAINS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10601-5000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-684-2779
Provider Business Practice Location Address Fax Number:
914-684-2688
Provider Enumeration Date:
03/22/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PALUMBO
Authorized Official First Name:
MICHAEL
Authorized Official Middle Name:
Authorized Official Title or Position:
AUTHORIZED OFFICIAL/CMO
Authorized Official Telephone Number:
914-681-1210

Provider Taxonomy Codes

  • Taxonomy code: 207K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207N00000X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RE0101X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207RP1001X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RR0500X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207XX0004X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZP0102X , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , 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)

  • Identifier: 185812 . This is a "LICENSE" identifier . This identifiers is of the category "OTHER".