1659310050 NPI number — MARCIA TAPPER M.D., LLC

Table of content: (NPI 1659310050)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659310050 NPI number — MARCIA TAPPER M.D., LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARCIA TAPPER M.D., LLC
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:
1659310050
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 367
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TEANECK
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07666-0367
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-273-2540
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11 RALPH PL
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
STATEN ISLAND
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10304-4419
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-273-2540
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TAPPER
Authorized Official First Name:
MARCIA
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
718-273-2540

Provider Taxonomy Codes

  • Taxonomy code: 207W00000X , with the licence number:  177241 , 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: 0499385 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 92H422 . This is a "EMPIRE PPO AND HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: TR7241 . This is a "ATLANTIS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1974863 . This is a "UNITED" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5830756 . This is a "AETNA PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 176772 . This is a "ELDERPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 205400101/201 . This is a "HEALTHPLUS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2186510 . This is a "AETNA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P2018334 . This is a "OXFORD AND OXFORD LIBERTY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5881672-002 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2C1922 . This is a "PHS AND TOUCHSTONE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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