1578177929 NPI number — AR PERSONAL MEDICAL CARE P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578177929 NPI number — AR PERSONAL MEDICAL CARE P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AR PERSONAL MEDICAL CARE 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:
1578177929
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/24/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 550
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:
10028-0019
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-762-8080
Provider Business Mailing Address Fax Number:
718-762-2079

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3726 76TH ST FL 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JACKSON HEIGHTS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11372-6508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-762-8080
Provider Business Practice Location Address Fax Number:
718-762-2079
Provider Enumeration Date:
09/03/2020

Additional Information

Authorized Official

Authorized Official Last Name:
ROMEO
Authorized Official First Name:
ANA
Authorized Official Middle Name:
I
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
212-334-4004

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 01565044 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com