1285938381 NPI number — ASIAN DIABETES CENTER LLC

Table of content: (NPI 1285938381)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285938381 NPI number — ASIAN DIABETES CENTER LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASIAN DIABETES CENTER LLC
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:
1285938381
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
185 CANAL STREET
Provider Second Line Business Mailing Address:
6TH FLOOR
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10013-4537
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-226-1177
Provider Business Mailing Address Fax Number:
212-625-2009

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
185 CANAL STREET
Provider Second Line Business Practice Location Address:
6TH FLOOR
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10013-4537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-226-1177
Provider Business Practice Location Address Fax Number:
212-625-2009
Provider Enumeration Date:
01/04/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LIU
Authorized Official First Name:
GEORGE
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
212-226-1177

Provider Taxonomy Codes

  • Taxonomy code: 207RE0101X , with the licence number:  140475 , 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)