1457720401 NPI number — JOHN J BROWNE DDS, EUGENE N GOETZ DDS, BENEDICT R MIRAGLIA DDS

Table of content: (NPI 1457720401)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457720401 NPI number — JOHN J BROWNE DDS, EUGENE N GOETZ DDS, BENEDICT R MIRAGLIA DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JOHN J BROWNE DDS, EUGENE N GOETZ DDS, BENEDICT R MIRAGLIA DDS
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:
DRS. BROWNE, GOETZ, & MIRAGLIA
Provider Other Organization Name Type Code:
5
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:
1457720401
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/21/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
280 N BEDFORD RD
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
MOUNT KISCO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10549-1141
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-241-1191
Provider Business Mailing Address Fax Number:
914-241-1254

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
280 N BEDFORD RD
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
MOUNT KISCO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10549-1141
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-241-1191
Provider Business Practice Location Address Fax Number:
914-241-1254
Provider Enumeration Date:
09/21/2015

Additional Information

Authorized Official

Authorized Official Last Name:
COHEN
Authorized Official First Name:
DEBRA
Authorized Official Middle Name:
C
Authorized Official Title or Position:
DENTAL ASSISTANT
Authorized Official Telephone Number:
914-241-1191

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  055947 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 122300000X , with the licence number: 055762 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 122300000X , with the licence number: 055726 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223G0001X , with the licence number: 35370 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1223G0001X , with the licence number: 040937 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1223G0001X , with the licence number: 044951 , 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)





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