1548298508 NPI number — PSYCHIATRY AND PSYCHOTHERAPY PRACTICE P.C.

Table of content: DR. LESLIE J. VANROMER D.C. (NPI 1487773362)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548298508 NPI number — PSYCHIATRY AND PSYCHOTHERAPY PRACTICE P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PSYCHIATRY AND PSYCHOTHERAPY PRACTICE P.C.
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:
1548298508
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/02/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 EAST 83RD STREET
Provider Second Line Business Mailing Address:
STE 19M
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10028-7244
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-239-0030
Provider Business Mailing Address Fax Number:
718-239-0032

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 EAST 83RD STREET
Provider Second Line Business Practice Location Address:
STE 19M
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10028-7244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-239-0030
Provider Business Practice Location Address Fax Number:
718-239-0032
Provider Enumeration Date:
06/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MURILLO
Authorized Official First Name:
MAURICIO
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
718-239-0030

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 02657587 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com