1679568141 NPI number — EUGENE SPAGNUOLO MD

Table of content: EUGENE SPAGNUOLO MD (NPI 1679568141)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1679568141 NPI number — EUGENE SPAGNUOLO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SPAGNUOLO
Provider First Name:
EUGENE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1679568141
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 E MAIN ST
Provider Second Line Business Mailing Address:
NORTHERN WESTCHESTER HOSPITAL EMERGENCY DEPARTMENT
Provider Business Mailing Address City Name:
MOUNT KISCO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10549-3417
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-666-1254
Provider Business Mailing Address Fax Number:
914-666-1931

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 E MAIN ST
Provider Second Line Business Practice Location Address:
NORTHERN WESTCHESTER HOSPITAL, MEDICAL AFFAIRS OFFICE
Provider Business Practice Location Address City Name:
MOUNT KISCO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10549-3417
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-242-8318
Provider Business Practice Location Address Fax Number:
914-666-1965
Provider Enumeration Date:
09/12/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X , with the licence number:  214071 , 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: 0000085141 . This is a "GHI HMO PIN #" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1059586 . This is a "CDPHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0511050000033 . This is a "FIDELIS CARE OF NY PIN#" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3883215 . This is a "AETNA HMO PIN#" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4798735 . This is a "GHI PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5804682 . This is a "AETNA PPO PIN#" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5C7517 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4147744 . This is a "MVP HEALTHPLAN PIN #" identifier . This identifiers is of the category "OTHER".
  • Identifier: P2791668 . This is a "OXFORD HEALTH PLAN PIN#" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0645R1 . This is a "EMPIRE BC BS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2233284 . This is a "UNITED HEALTHCARE PIN#" identifier . This identifiers is of the category "OTHER".




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