1932157773 NPI number — ALBERT A. ACKIL, M.D., INC.

Table of content: (NPI 1932157773)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932157773 NPI number — ALBERT A. ACKIL, M.D., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALBERT A. ACKIL, M.D., INC.
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:
1932157773
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/09/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 859207
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRAINTREE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02185-9207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-927-0014
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 ROCHE BROTHERS WAY
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
NORTH EASTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02356-1000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-238-3455
Provider Business Practice Location Address Fax Number:
508-238-2296
Provider Enumeration Date:
05/04/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ACKIL
Authorized Official First Name:
ALBERT
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
508-238-3455

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 9760504 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: O36162 . This is a "TUFTS HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 000000005517 . This is a "BMC HEALTH NET" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: M15003 . This is a "BCBS MA" identifier . This identifiers is of the category "OTHER".
  • Identifier: DA2422 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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