1427729011 NPI number — DOXI CARE

Table of content: (NPI 1427729011)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427729011 NPI number — DOXI CARE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DOXI CARE
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:
DOXICARE P.C.
Provider Other Organization Name Type Code:
4
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:
1427729011
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/03/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23 BIRD STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CANTON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13617
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
408-394-6222
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
76 FORT EDDY PLAZA #1031
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CONCORD
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03301-7404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
408-394-6222
Provider Business Practice Location Address Fax Number:
925-369-3453
Provider Enumeration Date:
09/23/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WEBER
Authorized Official First Name:
NICOLE
Authorized Official Middle Name:
LEANN
Authorized Official Title or Position:
OWNER, PRESIDENT
Authorized Official Telephone Number:
408-394-6222

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207VF0040X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207VG0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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