1427146232 NPI number — STARBRIDGE SERVICES INC

Table of content: (NPI 1427146232)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427146232 NPI number — STARBRIDGE SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STARBRIDGE SERVICES 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:
1427146232
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/22/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1650 SOUTH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ROCHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14620-3927
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
585-546-1700
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1650 SOUTH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ROCHESTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14620-3927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
585-546-1700
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
O'HARE
Authorized Official First Name:
TERRY
Authorized Official Middle Name:
Authorized Official Title or Position:
CHIEF FINANCIAL OFFICER
Authorized Official Telephone Number:
585-705-8424

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 02129748 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02216860 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02570038 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02693745 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02711571 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02713835 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02377080 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02623614 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02171722 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02354176 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02679849 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01895656 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02055136 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02567733 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02002064 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02247616 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01489436 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02752270 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




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