1396885828 NPI number — BILQUIS NAVIWALA PHYSICIAN PC INC

Table of content: (NPI 1396885828)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396885828 NPI number — BILQUIS NAVIWALA PHYSICIAN PC INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BILQUIS NAVIWALA PHYSICIAN PC INC
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:
1396885828
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
86 16 60TH AVE
Provider Second Line Business Mailing Address:
APT #2H
Provider Business Mailing Address City Name:
ELMHURST
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11373
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-386-4409
Provider Business Mailing Address Fax Number:
718-386-4409

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
252 WYCKOFF AVE
Provider Second Line Business Practice Location Address:
#1R
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11237
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-386-4409
Provider Business Practice Location Address Fax Number:
418-386-4409
Provider Enumeration Date:
02/07/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NAVIWALA
Authorized Official First Name:
BILQUIS
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
718-386-4409

Provider Taxonomy Codes

  • Taxonomy code: 208000000X , with the licence number:  197249 , 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: 197249 . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000423460666 . This is a "HEALTHPLUS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 060427000028 . This is a "CENTERCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 10211479 . This is a "AMERIGROUP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 008392 . This is a "METRO PLUS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 26P7723 . This is a "NEW YORK PRESBYTERIAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1000030765 . This is a "AFFINITY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 19724901 . This is a "NEIGHBORHOOD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01783435 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10211480 . This is a "AMERIGROUP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 11227421 . This is a "MULTIPLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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