1033587340 NPI number — MR. ROMAN JERRY BIHANSKY JR. PTA

Table of content: MR. ROMAN JERRY BIHANSKY JR. PTA (NPI 1033587340)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033587340 NPI number — MR. ROMAN JERRY BIHANSKY JR. PTA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BIHANSKY
Provider First Name:
ROMAN
Provider Middle Name:
JERRY
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
JR.
Provider Credential Text:
PTA
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BIHANSKY
Provider Other First Name:
ROMAN
Provider Other Middle Name:
JERRY
Provider Other Name Prefix Text:
MR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PTA
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1033587340
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/03/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
534 E 84TH ST
Provider Second Line Business Mailing Address:
APT 3E
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10028-7334
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:
534 E 84TH ST
Provider Second Line Business Practice Location Address:
APT 3E
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10028-7334
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-250-8142
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/03/2015

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: 225200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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