1407861214 NPI number — STUART D. KATCHIS, M.D., P.C.

Table of content: (NPI 1265824858)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407861214 NPI number — STUART D. KATCHIS, M.D., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STUART D. KATCHIS, M.D., P.C.
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:
1407861214
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
130 E 77TH ST
Provider Second Line Business Mailing Address:
12TH FLOOR
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10075-1851
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-434-4920
Provider Business Mailing Address Fax Number:
212-434-2844

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
130 E 77TH ST
Provider Second Line Business Practice Location Address:
12TH FLOOR
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10075-1851
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-434-4920
Provider Business Practice Location Address Fax Number:
212-434-2844
Provider Enumeration Date:
07/30/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KATCHIS
Authorized Official First Name:
STUART
Authorized Official Middle Name:
DEAN
Authorized Official Title or Position:
PRESIDENT/DOCTOR
Authorized Official Telephone Number:
212-434-4920

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  190026 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207XX0004X , with the licence number: 190026 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207XX0005X , with the licence number: 190026 , 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)