1427055789 NPI number — DR. ANGELO PORCARI M.D.

Table of content: DR. ANGELO PORCARI M.D. (NPI 1427055789)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427055789 NPI number — DR. ANGELO PORCARI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PORCARI
Provider First Name:
ANGELO
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1427055789
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
361 S 4TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FULTON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13069-2532
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-598-5373
Provider Business Mailing Address Fax Number:
315-598-2304

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
361 S 4TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FULTON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13069-2532
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-598-5373
Provider Business Practice Location Address Fax Number:
315-598-2304
Provider Enumeration Date:
07/01/2005

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: 207R00000X , with the licence number:  181477 , 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: 010647146 . This is a "EMPIRE PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 010647146 . This is a "POMCO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 990270 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4479 . This is a "TOTAL CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 010647146 . This is a "CIGNA HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 010647146 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 110060046 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000915959002 . This is a "HEALTHNOW" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01114900 . This is a "BLUE CROSS BLUE SHIELD UT" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2501803 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000002160 . This is a "BLUE CROSS BLUE SHIELD CE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01342709 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com