1720022759 NPI number — DR. AVI K PANDEY M.D.

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 1720022759 NPI number — DR. AVI K PANDEY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PANDEY
Provider First Name:
AVI
Provider Middle Name:
K
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PANDEY
Provider Other First Name:
AWADHESH
Provider Other Middle Name:
K
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1720022759
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8045 SURREY PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JAMAICA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11432-1450
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-454-1040
Provider Business Mailing Address Fax Number:
718-454-7992

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6118 190TH ST
Provider Second Line Business Practice Location Address:
SUITE 229
Provider Business Practice Location Address City Name:
FRESH MEADOWS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11365-2724
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-454-1040
Provider Business Practice Location Address Fax Number:
718-454-7992
Provider Enumeration Date:
06/16/2006

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: 207W00000X , with the licence number:  1716051 , 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: 0801348 . This is a "UNITED MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 113325410 . This is a "PHCS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0006748 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 159853 . This is a "ELDERPLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3938872 . This is a "1199 NATIONAL BENEFIT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01457221 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 113325410 . This is a "MAGNACARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 171605A71 . This is a "HEALTHFIRST MEDICAID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 36E361 . This is a "EMPIRE MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 113325410 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0C8079 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 113325410 . This is a "HORIZON" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1114040 . This is a "UNITEDHEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 180018329 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 113325410 . This is a "MULTIPLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 36E363 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 513607 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: DS459 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com