1598016933 NPI number — MS. ANNE LLAMOSO SONGCO N.P.

Table of content: MS. ANNE LLAMOSO SONGCO N.P. (NPI 1598016933)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598016933 NPI number — MS. ANNE LLAMOSO SONGCO N.P.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SONGCO
Provider First Name:
ANNE
Provider Middle Name:
LLAMOSO
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
N.P.
Provider Gender Code:
F

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:
1598016933
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/06/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
03/13/2013
NPI Reactivation Date:
09/04/2013

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6010 BAY PARKWAY
Provider Second Line Business Mailing Address:
SUITE 901
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11204
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-238-2100
Provider Business Mailing Address Fax Number:
718-534-5606

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6010 BAY PARKWAY
Provider Second Line Business Practice Location Address:
SUITE 901
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-238-2100
Provider Business Practice Location Address Fax Number:
718-534-5606
Provider Enumeration Date:
09/25/2012

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: 363LG0600X , with the licence number:  F340843-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LA2200X , with the licence number: F306043-1 , 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)





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