1558477240 NPI number — GENE T GIAMARINO PC

Table of content: (NPI 1558477240)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558477240 NPI number — GENE T GIAMARINO PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GENE T GIAMARINO 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:
6
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:
1558477240
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/06/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
421 73RD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11209-2609
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-748-0202
Provider Business Mailing Address Fax Number:
718-748-9777

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
421 73RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11209
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-748-0202
Provider Business Practice Location Address Fax Number:
718-748-9777
Provider Enumeration Date:
08/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GIAMARINO
Authorized Official First Name:
LISA
Authorized Official Middle Name:
Authorized Official Title or Position:
OFFICE MANAGER
Authorized Official Telephone Number:
718-748-0202

Provider Taxonomy Codes

  • Taxonomy code: 208100000X , with the licence number:  1239765 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208100000X , with the licence number: 005482 , 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: 3299543 . This is a "CIGNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0089897 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 49P0571 . This is a "NY PRESBYTERIAN COM HLTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: Q52191 . This is a "EMPIRE BCBS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 750603 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 807494 . This is a "NYSHIP THE EMPIRE PLAN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P1024328 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 907063 . This is a "FIRST HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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