1356624159 NPI number — MRS. PURA VASQUEZ DIAZ

Table of content: DR. FRANK RAYMOND SHARF D.O. (NPI 1457445744)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356624159 NPI number — MRS. PURA VASQUEZ DIAZ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VASQUEZ DIAZ
Provider First Name:
PURA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DIAZ
Provider Other First Name:
PURA
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1356624159
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/28/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
205 LEXINGTON AVE , 14 FL
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:
10016
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-398-3216
Provider Business Mailing Address Fax Number:
212-524-5163

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
120 HIGHLAND AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10940
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-342-1033
Provider Business Practice Location Address Fax Number:
845-344-5631
Provider Enumeration Date:
09/28/2011

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: 363LF0000X , with the licence number:  F335491-1 , 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)





Copyright © 2007-2025 www.npivalidator.com