1255541322 NPI number — FLAVIA ROBOTTI MD

Table of content: FLAVIA ROBOTTI MD (NPI 1255541322)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255541322 NPI number — FLAVIA ROBOTTI MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBOTTI
Provider First Name:
FLAVIA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1255541322
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/16/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
247 3RD AVE RM 401
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10010-7454
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-982-5006
Provider Business Mailing Address Fax Number:
212-475-0134

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
247 3RD AVE RM 401
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10010-7454
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-982-5006
Provider Business Practice Location Address Fax Number:
212-475-0134
Provider Enumeration Date:
05/23/2007

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: 2084P0015X , with the licence number:  145036 , 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: 56A821 . This is a "EMPIRE BLUE CROSS & BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: P1892880 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0059344 . This is a "GHI/BMP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00695941 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4413230 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 206769 . This is a "VALUE OPTIONS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00600871 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 56A823 . This is a "BLUE CROSS & BLUE SHIELD" identifier . This identifiers is of the category "OTHER".




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