1720180003 NPI number — CHARLES J ABATE MD

Table of content: CHARLES J ABATE MD (NPI 1720180003)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720180003 NPI number — CHARLES J ABATE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ABATE
Provider First Name:
CHARLES
Provider Middle Name:
J
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:
1720180003
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
110 S BEDFORD RD
Provider Second Line Business Mailing Address:
CARE MOUNT MEDICAL, P.C
Provider Business Mailing Address City Name:
MOUNT KISCO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10549-3446
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-241-1050
Provider Business Mailing Address Fax Number:
914-242-1516

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
310 N HIGHLAND AVE
Provider Second Line Business Practice Location Address:
CARE MOUNT MEDICAL, P.C
Provider Business Practice Location Address City Name:
OSSINING
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10562-6300
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-762-4141
Provider Business Practice Location Address Fax Number:
914-762-8350
Provider Enumeration Date:
09/05/2006

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: 207R00000X , with the licence number:  1700991 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RP1001X , with the licence number: 170099 , 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: 01349173 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: P01054302 . This is a "MEDICARE RAILROAD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1720180003 . This is a "NPI" identifier . This identifiers is of the category "OTHER".