1851421234 NPI number — ALL CAPE UROLOGY, P.C.

Table of content: (NPI 1851421234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851421234 NPI number — ALL CAPE UROLOGY, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALL CAPE UROLOGY, P.C.
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:
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:
1851421234
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/15/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 GLEASON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HYANNIS
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02601-5220
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-775-0667
Provider Business Mailing Address Fax Number:
508-775-6358

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 GLEASON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HYANNIS
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02601-5220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-775-0667
Provider Business Practice Location Address Fax Number:
508-775-6358
Provider Enumeration Date:
03/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PRIZZI
Authorized Official First Name:
ANTHONY
Authorized Official Middle Name:
RICHARD
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
508-775-0667

Provider Taxonomy Codes

  • Taxonomy code: 208800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 27142 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1900057 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9730516 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0000000296589 . This is a "BMC HEALTHNET PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1422778001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3120 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 719418 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".




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