1477610137 NPI number — ANDREW J. SZABO, MD, PLLC

Table of content: (NPI 1477610137)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477610137 NPI number — ANDREW J. SZABO, MD, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANDREW J. SZABO, MD, PLLC
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:
1477610137
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
860 5TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10021-5856
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-583-2816
Provider Business Mailing Address Fax Number:
212-734-0382

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
860 5TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10021-5856
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-583-2816
Provider Business Practice Location Address Fax Number:
212-734-0382
Provider Enumeration Date:
01/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SZABO
Authorized Official First Name:
ANDREW
Authorized Official Middle Name:
JOHN
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
212-583-2816

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  095936 , 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: 404646 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 246AF1 . This is a "EMPIRE BCBS PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P382697 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2432720 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00659623 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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