1033499934 NPI number — MR. ANDREW TAYLOR WAINWRIGHT CASAC #20543 NYS OAS

Table of content: LAURIE DEMPSEY BSN, MN (NPI 1578569836)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033499934 NPI number — MR. ANDREW TAYLOR WAINWRIGHT CASAC #20543 NYS OAS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WAINWRIGHT
Provider First Name:
ANDREW
Provider Middle Name:
TAYLOR
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
CASAC #20543 NYS OAS
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:
1033499934
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/23/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
SEVEN HOLLAND AVENUE
Provider Second Line Business Mailing Address:
SECOND FLOOR
Provider Business Mailing Address City Name:
WHITE PLAINS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10603-3317
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SEVEN HOLLAND AVENUE
Provider Second Line Business Practice Location Address:
SECOND FLOOR
Provider Business Practice Location Address City Name:
WHITE PLAINS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10603-3317
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-683-8050
Provider Business Practice Location Address Fax Number:
914-683-8054
Provider Enumeration Date:
08/23/2011

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: 101YA0400X , with the licence number:  20543CASAC , 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: 01037705 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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