1700102936 NPI number — VILLAGE OF BRIARCLIFF MANOR

Table of content: (NPI 1700102936)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700102936 NPI number — VILLAGE OF BRIARCLIFF MANOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
VILLAGE OF BRIARCLIFF MANOR
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:
6
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:
1700102936
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/07/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 519
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TARRYTOWN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10591-0519
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-366-4004
Provider Business Mailing Address Fax Number:
914-366-4111

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1111 PLEASANTVILLE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRIARCLIFF MANOR
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10510-1603
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-944-2787
Provider Business Practice Location Address Fax Number:
914-941-4837
Provider Enumeration Date:
04/13/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
ZEGARELLI
Authorized Official First Name:
PHILIP
Authorized Official Middle Name:
Authorized Official Title or Position:
VILLAGE MANAGER
Authorized Official Telephone Number:
914-944-2782

Provider Taxonomy Codes

  • Taxonomy code: 341600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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