1497848899 NPI number — JUANITO CAGUIAT JR PHYSICIAN, PLLC

Table of content: (NPI 1497848899)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497848899 NPI number — JUANITO CAGUIAT JR PHYSICIAN, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JUANITO CAGUIAT JR PHYSICIAN, 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:
1497848899
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/03/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
153 CRESCENT DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALBERTSON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11507-1103
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-625-2789
Provider Business Mailing Address Fax Number:
516-625-2789

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9303 90TH AVE FL 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WOODHAVEN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11421-2751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-850-1320
Provider Business Practice Location Address Fax Number:
718-850-6087
Provider Enumeration Date:
09/30/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CAGUIAT
Authorized Official First Name:
JUANITO
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT/ OWNER
Authorized Official Telephone Number:
718-850-1320

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X , with the licence number:  188263 , 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: 901231302 . This is a "AMERICHOICE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 167825 . This is a "ELDERPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01481185 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2516088 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 31-00573 . This is a "UHC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4C5829 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3943046 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P638639 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 227600 . This is a "WELLCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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