1841287687 NPI number — ROBBIN H HANSEN M.D.

Table of content: ROBBIN H HANSEN M.D. (NPI 1841287687)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841287687 NPI number — ROBBIN H HANSEN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HANSEN
Provider First Name:
ROBBIN
Provider Middle Name:
H
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:
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:
1841287687
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/02/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
25 E MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SPRINGVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14141-1244
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-592-2832
Provider Business Mailing Address Fax Number:
716-592-4452

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
25 E MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SPRINGVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14141-1244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-592-2832
Provider Business Practice Location Address Fax Number:
716-592-4452
Provider Enumeration Date:
10/05/2005

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: 208000000X , with the licence number:  169858 , 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: 00010072704 . This is a "UNIVERA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000510187010 . This is a "BC/BS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 040426000853 . This is a "FIDELIS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 146922DL . This is a "PREFERRED CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01018524 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1208950 . This is a "IHA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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