1437318573 NPI number — DR. ROBERT FEKETE M.D.

Table of content: DR. ROBERT FEKETE M.D. (NPI 1437318573)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437318573 NPI number — DR. ROBERT FEKETE M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FEKETE
Provider First Name:
ROBERT
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1437318573
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/19/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19 BRADHURST AVE STE 3100N
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAWTHORNE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10532-2140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-909-9018
Provider Business Mailing Address Fax Number:
914-909-9028

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19 BRADHURST AVE
Provider Second Line Business Practice Location Address:
SUITE 2850
Provider Business Practice Location Address City Name:
HAWTHORNE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10532-2140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-345-1313
Provider Business Practice Location Address Fax Number:
914-345-5004
Provider Enumeration Date:
06/04/2008

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: 2084N0400X , with the licence number:  248606 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084N0400X , with the licence number: N1632 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0006681 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: A400203778 . This is a "MEDICARE APS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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