1144260910 NPI number — ERNST, SY AND MENON

Table of content: (NPI 1144260910)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144260910 NPI number — ERNST, SY AND MENON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ERNST, SY AND MENON
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:
1144260910
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/30/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1786
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10451-1786
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-901-8154
Provider Business Mailing Address Fax Number:
718-901-8151

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1770 GRAND CONCOURSE
Provider Second Line Business Practice Location Address:
#2G
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10457-5524
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-518-5581
Provider Business Practice Location Address Fax Number:
718-299-1877
Provider Enumeration Date:
06/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SY
Authorized Official First Name:
ERNESTO
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
718-518-5420

Provider Taxonomy Codes

  • Taxonomy code: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 00491323 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com