1437163508 NPI number — DR. BRAULIO FLORES MD

Table of content: DR. BRAULIO FLORES MD (NPI 1437163508)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437163508 NPI number — DR. BRAULIO FLORES MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FLORES
Provider First Name:
BRAULIO
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1437163508
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
63 WOODFIELD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRIARCLIFF
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10510-1933
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-747-0412
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
85 PONDFIELD RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRONXVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10708-3814
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-961-8500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/27/2006

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:  223994-1 , 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: 11023708400 . This is a "RAILROAD MCR" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 260500720 . This is a "MAGNACARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3705930 . This is a "AETNA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: O739492 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 219924601 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5333768 . This is a "AETNA PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2239941 . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 6C5961 . This is a "HEALTH NET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0174622 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P3400556 . This is a "OXFORD & OXFORD MCR" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 260500720 . This is a "1199 NATIONAL BENEFIT FUND" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 683AC1 . This is a "B/C B/S" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000000119735 . This is a "GHI HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 260500720 . This is a "POMCO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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