1548769029 NPI number — RAFFI BARSOUMIAN MD MEDICAL TREATMENTS PC

Table of content: (NPI 1548769029)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548769029 NPI number — RAFFI BARSOUMIAN MD MEDICAL TREATMENTS PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RAFFI BARSOUMIAN MD MEDICAL TREATMENTS PC
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:
1548769029
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/09/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
228 E ROUTE 59 STE 248
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NANUET
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10954-2905
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-287-1120
Provider Business Mailing Address Fax Number:
718-845-6464

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15817 97TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOWARD BEACH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11414-3228
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-845-5252
Provider Business Practice Location Address Fax Number:
718-845-6464
Provider Enumeration Date:
02/09/2018

Additional Information

Authorized Official

Authorized Official Last Name:
BARSOUMIAN
Authorized Official First Name:
RAFFI
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
516-287-1120

Provider Taxonomy Codes

  • Taxonomy code: 208D00000X , with the licence number:  240858 , 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)





Copyright © 2007-2025 www.npivalidator.com