1134120140 NPI number — DR. ROBERT A CRAFTS M.D.

Table of content: DR. ROBERT A CRAFTS M.D. (NPI 1134120140)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134120140 NPI number — DR. ROBERT A CRAFTS M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRAFTS
Provider First Name:
ROBERT
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1134120140
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/10/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1201 NOTT ST
Provider Second Line Business Mailing Address:
SUITE 106
Provider Business Mailing Address City Name:
SCHENECTADY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12308-2589
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-374-3123
Provider Business Mailing Address Fax Number:
518-374-9711

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1201 NOTT ST
Provider Second Line Business Practice Location Address:
SUITE 106
Provider Business Practice Location Address City Name:
SCHENECTADY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12308-2589
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-374-3123
Provider Business Practice Location Address Fax Number:
518-374-9711
Provider Enumeration Date:
08/02/2005

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: 207L00000X , with the licence number:  122742-1 , 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: B80761 . This is a "AMERICAN PROGRESSIVE TODA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 33570M . This is a "FIDELIS MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: RC03Y76120 . This is a "EMPIRE BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000084078 . This is a "GHI HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: AN1227420 . This is a "WORKERS COMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3Y761 . This is a "EMPIRE BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10000408 . This is a "CDPHP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 122742-1 . This is a "TRICARE NORTH REGION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000405056003 . This is a "BLUE SHIELD NENY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 040426006648 . This is a "FIDELIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 05103 . This is a "MVP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 110160500 . This is a "US DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5301141 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000405056001 . This is a "BLUE SHIELD NENY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00392838 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: AN1227420 . This is a "NO FAULT" identifier . This identifiers is of the category "OTHER".
  • Identifier: RC03Y76110 . This is a "EMPIRE BLUE CROSS" identifier . This identifiers is of the category "OTHER".




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