1548560683 NPI number — ASSISTANCE BY IMPROV II, INC

Table of content: (NPI 1548560683)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548560683 NPI number — ASSISTANCE BY IMPROV II, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSISTANCE BY IMPROV II, 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:
ABI II,INC.
Provider Other Organization Name Type Code:
3
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:
1548560683
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
144 VAN CORTLANDT PARK S
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRONX
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10463-2505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
929-263-1242
Provider Business Mailing Address Fax Number:
646-401-7420

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
953 SOUTHERN BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRONX
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10459-3428
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
929-263-1242
Provider Business Practice Location Address Fax Number:
646-401-7420
Provider Enumeration Date:
10/22/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
WRIGHT
Authorized Official First Name:
JOE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
929-263-1242

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  077816 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WC1500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WN1003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 164W00000X , with the licence number: 192940-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251B00000X , with the licence number: 041-O-100 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 343900000X , 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: 02103304 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02241541 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1276581080 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02757133 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1146254997 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02100810 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01478519 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02845976 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".