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

Table of content: (NPI 1053450312)

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:
NEXT GENERATION EYE CARE
Provider Other Organization Name Type Code:
3
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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