1154652998 NPI number — ZVI JON BATASH MD PC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154652998 NPI number — ZVI JON BATASH MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ZVI JON BATASH MD PC
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:
1154652998
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/07/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
65-11 BOOTH STREET
Provider Second Line Business Mailing Address:
SUITE 1C
Provider Business Mailing Address City Name:
REGO PARK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11374-4184
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-806-1434
Provider Business Mailing Address Fax Number:
718-806-1435

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
65-11 BOOTH STREET
Provider Second Line Business Practice Location Address:
SUITE 1C
Provider Business Practice Location Address City Name:
REGO PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11374-4184
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-806-1434
Provider Business Practice Location Address Fax Number:
718-806-1435
Provider Enumeration Date:
01/19/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
BATASH
Authorized Official First Name:
ZVI
Authorized Official Middle Name:
JON
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
917-686-6162

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  254557 , 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: 03157013 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".