1902864473 NPI number — GREGG FELD MD

Table of content: POOJA POLADIA PHARMD (NPI 1679208045)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902864473 NPI number — GREGG FELD MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FELD
Provider First Name:
GREGG
Provider Middle Name:
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:
1902864473
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 8000
Provider Second Line Business Mailing Address:
DEPT 836
Provider Business Mailing Address City Name:
BUFFALO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14267
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
222 GENESEE STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BUFFALO
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-855-2866
Provider Business Practice Location Address Fax Number:
716-855-2860
Provider Enumeration Date:
05/03/2006

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: 2085R0202X , with the licence number:  1903591 , 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: 00025344807 . This is a "UNIVERA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000525472013 . This is a "BLUE SHIELD OF WESTERN NY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 161425463 . This is a "EMPIRE PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 204329201 . This is a "EMPIRE PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 743079229 . This is a "EMPIRE PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000525472010 . This is a "BLUE SHIELD OF WESTERN NY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 145800FF . This is a "PREFERRED CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0025344806 . This is a "UNIVERA" identifier . This identifiers is of the category "OTHER".
  • Identifier: W1903590W . This is a "WORKERS COMPENSATION" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000525472011 . This is a "BLUE SHIELD OF WESTERN NY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5605277 . This is a "INDEPENDENT HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000525472006 . This is a "BLUE SHIELD OF WESTERN NY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0025344805 . This is a "UNIVERA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01357166 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 161538169 . This is a "EMPIRE PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 040426001304 . This is a "FIDELIS" identifier . This identifiers is of the category "OTHER".




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