1396740973 NPI number — MRS. DEBORAH KAY WHITE P.T.

Table of content: MRS. DEBORAH KAY WHITE P.T. (NPI 1396740973)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396740973 NPI number — MRS. DEBORAH KAY WHITE P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WHITE
Provider First Name:
DEBORAH
Provider Middle Name:
KAY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
P.T.
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:
1396740973
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4250 HEMPSTEAD TPKE
Provider Second Line Business Mailing Address:
STE 1
Provider Business Mailing Address City Name:
BETHPAGE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11714-5707
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-579-7870
Provider Business Mailing Address Fax Number:
516-579-7867

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4250 HEMPSTEAD TPKE
Provider Second Line Business Practice Location Address:
STE 1
Provider Business Practice Location Address City Name:
BETHPAGE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11714-5707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-579-7870
Provider Business Practice Location Address Fax Number:
516-579-7867
Provider Enumeration Date:
06/20/2005

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: 225100000X , with the licence number:  005258-1 , 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: 112807278 . This is a "HORIZON HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 112807278 . This is a "HEALTHNET (TRICARE NORTH)" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 112807278 . This is a "METRACOMP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 112807278 . This is a "PHCS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 112807278 . This is a "ACCESS MANAGED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3514 . This is a "VYTRA HEALTH PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000080279 . This is a "GHI HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 112807278 . This is a "MAGNACARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4360072 . This is a "AETNA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 650013195 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 112807278 . This is a "MULTIPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 112807278 . This is a "RISING MEDICAL SOLUTIONS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: ANC1170 . This is a "OXFORD HEALTH PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 20089P . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 6600523 . This is a "GHI PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 934808 . This is a "FIRST HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: Q53971 . This is a "BLUSCROSS/BLUESHIELD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0090294 . This is a "AETNA USHC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 373633 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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