1598844706 NPI number — CUTIE PHARMA-CARE, INC

Table of content: (NPI 1598844706)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598844706 NPI number — CUTIE PHARMA-CARE, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CUTIE PHARMA-CARE, 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:
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:
1598844706
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
114 MAIN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENWICH
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12834-1215
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-692-8500
Provider Business Mailing Address Fax Number:
518-692-8552

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
114 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENWICH
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12834-1215
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-692-8500
Provider Business Practice Location Address Fax Number:
518-692-8552
Provider Enumeration Date:
11/06/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GOULTY
Authorized Official First Name:
MARILYN
Authorized Official Middle Name:
J
Authorized Official Title or Position:
CFO
Authorized Official Telephone Number:
518-692-8500

Provider Taxonomy Codes

  • Taxonomy code: 3336L0003X , with the licence number:  025438 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 3336M0002X , with the licence number: NR0308 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 3336M0002X , with the licence number: ME244459 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 3336M0002X , with the licence number: 036-0000035 , registered in the state of VT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 3336M0002X , with the licence number: PH09757 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 3336M0002X , with the licence number: 649 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 02311782 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 3327081 . This is a "NCPDP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".