1407090186 NPI number — DR. MEREDITH GAIL SLUTZAH-BERNSTEIN D.O

Table of content: DR. MEREDITH GAIL SLUTZAH-BERNSTEIN D.O (NPI 1407090186)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407090186 NPI number — DR. MEREDITH GAIL SLUTZAH-BERNSTEIN D.O

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SLUTZAH-BERNSTEIN
Provider First Name:
MEREDITH
Provider Middle Name:
GAIL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SLUTZAH
Provider Other First Name:
MEREDITH
Provider Other Middle Name:
GAIL
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.O
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1407090186
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/27/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 COMMUNITY DR
Provider Second Line Business Mailing Address:
DIVISION OF NEONATAL-PERINATAL MEDICINE
Provider Business Mailing Address City Name:
MANHASSET
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11030-3816
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-562-4665
Provider Business Mailing Address Fax Number:
516-562-4516

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
270 PARK AVE
Provider Second Line Business Practice Location Address:
DIVISION OF NEONATAL-PERINATAL MEDICINE
Provider Business Practice Location Address City Name:
HUNTINGTON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11743-2787
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-351-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/27/2009

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: 2080N0001X , with the licence number:  240311 , 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)





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