1528051869 NPI number — DR. EDWARD A APICELLA MD

Table of content: DR. EDWARD A APICELLA MD (NPI 1528051869)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528051869 NPI number — DR. EDWARD A APICELLA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
APICELLA
Provider First Name:
EDWARD
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1528051869
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/28/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12 CORPORATE WOODS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALBANY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12211-2524
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-463-0171
Provider Business Mailing Address Fax Number:
518-463-0174

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12 CORPORATE WOODS BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ALBANY
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12211-2524
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-463-0171
Provider Business Practice Location Address Fax Number:
518-463-0174
Provider Enumeration Date:
08/23/2005

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: 207LP2900X , with the licence number:  191595 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208VP0014X , with the licence number: 191595 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 208VP0000X , with the licence number: 191595 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 01565035 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5403572 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000405461007 . This is a "BSNENY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 05641 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 10000049 . This is a "CDPHP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4868 . This is a "CDPHP GROUP #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: EA03087930 . This is a "EMPIRE/ BLUE CHOICE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 110586100 . This is a "DEPT OF LABOR/POSTAL WORK" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 141806863 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5508704 . This is a "GHI PPO GROUP NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 050078269 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5301566 . This is a "GHI PPO DR. APICELLA'S #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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