1053450312 NPI number — MARCEL MORDECHAI ADMONI, M.D., P.C.

Table of content: MARGARET LYNN BELLOWS LPC (NPI 1235544735)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053450312 NPI number — MARCEL MORDECHAI ADMONI, M.D., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MARCEL MORDECHAI ADMONI, M.D., P.C.
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:
6
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:
1053450312
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/05/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
54 RADNOR RD
Provider Second Line Business Mailing Address:
NEXT GENERATION EYE CARE
Provider Business Mailing Address City Name:
GREAT NECK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11023-1429
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-482-5775
Provider Business Mailing Address Fax Number:
516-482-2336

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3457 82ND ST STE 1F
Provider Second Line Business Practice Location Address:
NEXT GENERATION EYE CARE
Provider Business Practice Location Address City Name:
JACKSON HEIGHTS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11372-2930
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-446-8100
Provider Business Practice Location Address Fax Number:
516-482-2336
Provider Enumeration Date:
02/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ADMONI
Authorized Official First Name:
MARCEL
Authorized Official Middle Name:
MORDECHAI
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
516-482-5775

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207W00000X , with the licence number: 191748 , 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: 331630101 . This is a "HEALTH PLUS KEW GARDENS H" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 331630102 . This is a "HEALH PLUS JACKSON HEIGHT" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0400770 . This is a "GHI CBP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 660000 . This is a "HCPIPA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: QN00100 . This is a "AMERICHOICE NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 184622P . This is a "HIP PRIS KGH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 31590P . This is a "HIP PRIS JH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1000039036 . This is a "AFFINITY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 191748-A27 . This is a "HEALTHFIRST KEW GARDENS H" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 433B71 . This is a "EMPIRE BCBS JACKSON HEIGH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P379137 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1269964 . This is a "UNITEDHEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 040426017816 . This is a "FIDELIS CARE NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 168287 . This is a "ELDERPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 191748 . This is a "NYS LICENSE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01490862 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 191748-B-27 . This is a "HEALTHFIRST JACKSON HEIGH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 433B72 . This is a "EMPIRE BCBS KEW GARDENS H" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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