1992960728 NPI number — MANHATTAN COLORECTAL SURGICAL UNIT

Table of content: BRENDA CHERYL DUKAS F.N.P. (NPI 1134342660)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992960728 NPI number — MANHATTAN COLORECTAL SURGICAL UNIT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MANHATTAN COLORECTAL SURGICAL UNIT
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:
1992960728
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
36 7TH AVE
Provider Second Line Business Mailing Address:
SUITE 522
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10011-6609
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-675-2997
Provider Business Mailing Address Fax Number:
212-627-8389

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
36 7TH AVE
Provider Second Line Business Practice Location Address:
SUITE 522
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10011-6609
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-675-2997
Provider Business Practice Location Address Fax Number:
212-627-8389
Provider Enumeration Date:
07/21/2008

Additional Information

Authorized Official

Authorized Official Last Name:
PENZER
Authorized Official First Name:
JASON
Authorized Official Middle Name:
ROSS
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
212-675-2997

Provider Taxonomy Codes

  • Taxonomy code: 261QE0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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