1538138409 NPI number — JEFFREY AINSPAN M.D., P.C.

Table of content: (NPI 1538138409)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538138409 NPI number — JEFFREY AINSPAN M.D., P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JEFFREY AINSPAN M.D., P.C.
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:
1538138409
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/24/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
72 EILEEN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAHWAH
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07430-2806
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
201-327-8704
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
308A E 15TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10003-4001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-505-5790
Provider Business Practice Location Address Fax Number:
212-505-6511
Provider Enumeration Date:
03/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
AINSPAN
Authorized Official First Name:
ELLIE
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
201-788-5272

Provider Taxonomy Codes

  • Taxonomy code: 207NS0135X , with the licence number:  155051 , 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: 1000003251 . This is a "AFFINITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 155051-H20 . This is a "HEALTHFIRST" identifier . This identifiers is of the category "OTHER".
  • Identifier: 990121 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 155051 . This is a "HIP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 70D571 . This is a "EMPIRE BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: P852474 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 000000092884 . This is a "GHI HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0014933 . This is a "GHI PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: AINSJ064 . This is a "GREAT WEST ONE HEALTHPLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 11112286 . This is a "MULTIPLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4C5623 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 171185 . This is a "ELDERPLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5317347 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2340394 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31496 . This is a "HIP CMO" identifier . This identifiers is of the category "OTHER".




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