1396946836 NPI number — ANOTHER STEP

Table of content: (NPI 1396946836)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396946836 NPI number — ANOTHER STEP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANOTHER STEP
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:
1396946836
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23 W CENTRAL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PEARL RIVER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10965-2320
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-920-0710
Provider Business Mailing Address Fax Number:
845-920-0173

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23 W CENTRAL AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PEARL RIVER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10965-2320
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-920-0710
Provider Business Practice Location Address Fax Number:
845-920-0173
Provider Enumeration Date:
05/31/2007

Additional Information

Authorized Official

Authorized Official Last Name:
FLYNN
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
845-920-0710

Provider Taxonomy Codes

  • Taxonomy code: 251C00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 01895803 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02061810 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02111104 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02170607 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02189971 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02356870 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01736378 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01995931 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02749200 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01492108 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02291041 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02517426 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02513160 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01805678 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01955751 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02692419 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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