1033623178 NPI number — ADVANCED CARE ASSOCIATES LLC

Table of content: DR. CHAD DECKER VOGELGESANG DC (NPI 1861702862)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033623178 NPI number — ADVANCED CARE ASSOCIATES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED CARE ASSOCIATES LLC
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:
1033623178
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/13/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
455 NORTH END AVE GROUND FL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10282-5383
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-522-1340
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
455 NORTH END AVENUE, GROUND FLOOR
Provider Second Line Business Practice Location Address:
WELNESS CENTER
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10282-5383
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-522-1340
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/28/2017

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MAINI
Authorized Official First Name:
ARCHANA
Authorized Official Middle Name:
Authorized Official Title or Position:
HEMATOLOGIST AND ONCOLOGIST
Authorized Official Telephone Number:
917-522-1340

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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