1841217270 NPI number — ALEXANDER BORISOVICH BANKOV M.D.

Table of content: DERRICK WILLIAMS (NPI 1326731720)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841217270 NPI number — ALEXANDER BORISOVICH BANKOV M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BANKOV
Provider First Name:
ALEXANDER
Provider Middle Name:
BORISOVICH
Provider Name Prefix Text:
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:
BANKOV
Provider Other First Name:
ALEKSANDR
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841217270
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/13/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
114 MAPLEWOOD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BEAVER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15009-1337
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-709-9885
Provider Business Mailing Address Fax Number:
724-774-1517

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
114 MAPLEWOOD DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BEAVER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15009-1337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-709-9885
Provider Business Practice Location Address Fax Number:
724-774-1517
Provider Enumeration Date:
07/15/2006

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: 207L00000X , with the licence number:  MD073454L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0019034270001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01903427-09 . This is a "AMERICHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 30563 . This is a "HEALTH PARTNERS FRANKFORD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1401878 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2090439000 . This is a "KEYSTONE IBC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 30002948 . This is a "KEYSTONE MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 01697 . This is a "HEALTH PARTNERS TORRES." identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 050090907 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3056444 . This is a "AETNA CONTRACT" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 30567 . This is a "HEALTH PARTNERS BUCKS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0019034270002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1401878 . This is a "PERSONAL CHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1588043 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2203491 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2026 www.npivalidator.com