1922186204 NPI number — MR. RUY CHEN TIO D.O.

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922186204 NPI number — MR. RUY CHEN TIO D.O.

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

TIO

Provider First Name:

RUY

Provider Middle Name:

CHEN

Provider Name Prefix Text:

MR.

Provider Name Suffix Text:

Provider Credential Text:

D.O.

Provider Gender Code:

M

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:

1922186204

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

02/19/2009

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

1715 EAST 17TH STREET

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

BROOKLYN

Provider Business Mailing Address State Name:

NY

Provider Business Mailing Address Postal Code:

11229

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

718-336-1015

Provider Business Mailing Address Fax Number:

718-375-0810

Provider First Line Business Practice Location Address:

1715 EAST 17TH STREET

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

BROOKLYN

Provider Business Practice Location Address State Name:

NY

Provider Business Practice Location Address Postal Code:

11229

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

718-336-1015

Provider Business Practice Location Address Fax Number:

718-375-0810

Provider Enumeration Date:

11/02/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207K00000X , with the licence number:  184647 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
• Taxonomy code: 207R00000X , with the licence number: 184647 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

• Identifier: 01356885 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
• Identifier: 1000017395 . This is a "AFFINITY" identifier . This identifiers is of the category "OTHER".
• Identifier: 160178O . This is a "HIP BROOKLYN OFFICE" identifier . This identifiers is of the category "OTHER".
• Identifier: 69K841 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
• Identifier: 3246 . This is a "GENESIS" identifier . This identifiers is of the category "OTHER".
• Identifier: 6100378 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
• Identifier: 032640 . This is a "BETTER HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 0508978 . This is a "AETNA US HEALTH NASSAU" identifier . This identifiers is of the category "OTHER".
• Identifier: 1068855 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
• Identifier: 5303335 . This is a "AETNA US HEALTH BROOKLYN" identifier . This identifiers is of the category "OTHER".
• Identifier: 00323500102 . This is a "HEALTH PLUS" identifier . This identifiers is of the category "OTHER".
• Identifier: 160180P . This is a "HIP QUEENS OFFICE" identifier . This identifiers is of the category "OTHER".
• Identifier: 71824 . This is a "ANTHEM HEALTH NETWORK" identifier . This identifiers is of the category "OTHER".