1700223039 NPI number — FPA HOSPITAL BASED

Table of content: (NPI 1700223039)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700223039 NPI number — FPA HOSPITAL BASED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FPA HOSPITAL BASED
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:
ANESTHESIOLOGY DEPARTMENT OF MOUNT SINAI
Provider Other Organization Name Type Code:
3
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:
1700223039
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 5024
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:
10087-5024
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-627-4470
Provider Business Mailing Address Fax Number:
412-937-5710

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 GUSTAVE L LEVY PL
Provider Second Line Business Practice Location Address:
ANESTHESIOLOGY - BOX 1010
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10029-6500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-241-6426
Provider Business Practice Location Address Fax Number:
212-876-3906
Provider Enumeration Date:
05/28/2013

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MACNEILL
Authorized Official First Name:
CRYSTAL
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT, REVENUE CBO DIRECTO
Authorized Official Telephone Number:
212-731-6802

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207LC0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207LP2900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207LP3000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2081P2900X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208VP0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208VP0014X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367500000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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