1962479634 NPI number — MR. MICHAEL PETER RALBOVSKY FNP

Table of content: MR. MICHAEL PETER RALBOVSKY FNP (NPI 1962479634)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962479634 NPI number — MR. MICHAEL PETER RALBOVSKY FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RALBOVSKY
Provider First Name:
MICHAEL
Provider Middle Name:
PETER
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
FNP
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:
1962479634
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/05/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2128 ELMWOOD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BUFFALO
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14207-1910
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-566-5007
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2128 ELMWOOD AVE
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:
14207-1910
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-566-5007
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/02/2006

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: 363LF0000X , with the licence number:  F3343491 , 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: 000268570001 . This is a "UNIVERA COMMERCIAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00026857001 . This is a "ASO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000560900001 . This is a "COMMUNITY BLUE STANDARD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01465154 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7599258 . This is a "GROUP HEALTH INS PPO CMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000560900001 . This is a "BCBS WNY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000560900001 . This is a "COMMUNITY CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 041116000013 . This is a "FIDELIS FAMILY HEALTH PLU" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000560900001 . This is a "SENIOR BLUE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000560900001 . This is a "CHILD HEALTH PLUS FAMILY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 041116000013 . This is a "FIEDLIS CHILD HEALTH PLUS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000262857001 . This is a "UNIVERA HEALTHCARE TRADIT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000560900001 . This is a "CB LABOR HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 041116000013 . This is a "FIDELIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000092079 . This is a "GROUP HEALTH INS HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000560900001 . This is a "CB ADVANTAGE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000560900001 . This is a "TRADITIONAL SECURE BLUE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00056090001 . This is a "HMO 100" identifier . This identifiers is of the category "OTHER".




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