1407144694 NPI number — MEL KAPLAN MD PC

Table of content: (NPI 1407144694)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407144694 NPI number — MEL KAPLAN MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEL KAPLAN 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:
1407144694
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
234 4TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENPORT
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11944-1526
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-477-1720
Provider Business Mailing Address Fax Number:
631-477-8983

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
234 4TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENPORT
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11944-1526
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-477-1720
Provider Business Practice Location Address Fax Number:
631-477-8983
Provider Enumeration Date:
07/21/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
KAPLAN
Authorized Official First Name:
MEL
Authorized Official Middle Name:
B.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
631-477-1720

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)