1093723710 NPI number — MS. MARTHA W TAYLOR CNS

Table of content: MS. MARTHA W TAYLOR CNS (NPI 1093723710)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093723710 NPI number — MS. MARTHA W TAYLOR CNS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TAYLOR
Provider First Name:
MARTHA
Provider Middle Name:
W
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CNS
Provider Gender Code:
F

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:
1093723710
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/19/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
108 LINWOOD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORTH BELLMORE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11710-2409
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-221-8924
Provider Business Mailing Address Fax Number:
516-783-8246

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
108 LINWOOD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTH BELLMORE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11710-2409
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-221-8924
Provider Business Practice Location Address Fax Number:
516-783-8246
Provider Enumeration Date:
08/04/2006

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: 364SP0809X , with the licence number:  305202 , 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: 076750 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 190611 . This is a "MHN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 305202-A27 . This is a "HEALTH FIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 032097 . This is a "CNS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2734122 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7493800 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 54361 . This is a "UNITED BEHAVIORAL HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 03187139 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4633877 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 29936 . This is a "ANTHEM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 080860000 . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com