1952368615 NPI number — PETER JOHN PSARRAS MD

Table of content: PETER JOHN PSARRAS MD (NPI 1952368615)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952368615 NPI number — PETER JOHN PSARRAS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PSARRAS
Provider First Name:
PETER
Provider Middle Name:
JOHN
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:
PSARRAS CASTRO
Provider Other First Name:
PETER
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1952368615
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
GR 20 VIA 15
Provider Second Line Business Mailing Address:
VILLA FONTANA
Provider Business Mailing Address City Name:
CAROLINA
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00983
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-752-0081
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 AVE LAUREL
Provider Second Line Business Practice Location Address:
HOSPITAL REGIONAL BAYAMON SANTA JUANITA
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00956
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-787-5151
Provider Business Practice Location Address Fax Number:
787-787-5151
Provider Enumeration Date:
04/27/2006

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: 208600000X , with the licence number:  11151 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 89112PS . This is a "SSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 600088 . This is a "MMM" identifier . This identifiers is of the category "OTHER".
  • Identifier: PE3571 . This is a "PAN AMERICAN LIFE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5014 . This is a "NUMBER ESPECIALIDAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7000006778 . This is a "ELECTRONIC MEDIA CLAIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 204264 . This is a "UTI PREFERRED HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 32735 . This is a "ASOCIACION MAESTROS PR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3378 . This is a "AMERICAN HEALTH INC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 89112PS . This is a "TRIPLES" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 060673 . This is a "CRUZ AZUL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9560073 . This is a "HUMANA" identifier . This identifiers is of the category "OTHER".




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