1992701510 NPI number — BATAVIA INTERNAL MEDICINE ASSOCIATES, PLLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992701510 NPI number — BATAVIA INTERNAL MEDICINE ASSOCIATES, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BATAVIA INTERNAL MEDICINE ASSOCIATES, PLLC
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:
DR. JAVEED MIR AND DR. ROZY NELOFAR WANI
Provider Other Organization Name Type Code:
3
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:
1992701510
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/22/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
34 SWAN ST
Provider Second Line Business Mailing Address:
STE 3
Provider Business Mailing Address City Name:
BATAVIA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14020-3232
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-343-4441
Provider Business Mailing Address Fax Number:
585-345-1590

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
34 SWAN ST
Provider Second Line Business Practice Location Address:
STE 3
Provider Business Practice Location Address City Name:
BATAVIA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14020-3232
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-343-4441
Provider Business Practice Location Address Fax Number:
585-345-1590
Provider Enumeration Date:
06/28/2005

Additional Information

Authorized Official

Authorized Official Last Name:
MIR
Authorized Official First Name:
JAVEED
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
585-343-4441

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  190901-1 & 211016-1 , 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: 00020552304 . This is a "UNIVERA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000525640004 . This is a "COMM. BLUE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01948645 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2504379 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2596786 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000529997007 . This is a "COMM. BLUE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: MDF289 . This is a "PREFERRED CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01547373 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 00010284803 . This is a "UNIVERA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0409504 . This is a "INDEPENDENT HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P010211016 . This is a "BLUE CHOICE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0410492 . This is a "INDEPENDENT HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: MDB219 . This is a "PREFERRED CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P010190901 . This is a "BLUE CHOICE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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