1972511939 NPI number — DR. ARTHUR G NATHAN DDS

Table of content: AMANDA DEE STRAUB CRNA (NPI 1053596973)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972511939 NPI number — DR. ARTHUR G NATHAN DDS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NATHAN
Provider First Name:
ARTHUR
Provider Middle Name:
G
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DDS
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:
1972511939
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/20/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
294 W MERRICK RD
Provider Second Line Business Mailing Address:
SUITE 11
Provider Business Mailing Address City Name:
FREEPORT
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11520
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-378-4140
Provider Business Mailing Address Fax Number:
516-378-4529

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
294 W MERRICK RD
Provider Second Line Business Practice Location Address:
SUITE 11
Provider Business Practice Location Address City Name:
FREEPORT
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11520
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-378-4140
Provider Business Practice Location Address Fax Number:
516-378-4529
Provider Enumeration Date:
08/04/2006

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: 122300000X , with the licence number:  027312 , 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)