1609979079 NPI number — MR. ANDREW H KRINSKY MD

Table of content: MR. ANDREW H KRINSKY MD (NPI 1609979079)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609979079 NPI number — MR. ANDREW H KRINSKY MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KRINSKY
Provider First Name:
ANDREW
Provider Middle Name:
H
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1609979079
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/06/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7401 N UNIVERSITY DRIVE
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
TAMARAC
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33321-2934
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
954-722-2002
Provider Business Mailing Address Fax Number:
954-722-2041

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7401 N UNIVERSITY DRIVE
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
TAMARAC
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33321-2934
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
954-722-2002
Provider Business Practice Location Address Fax Number:
954-722-2041
Provider Enumeration Date:
09/07/2006

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: 207VG0400X , with the licence number:  ME46476 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 30852Y . This is a "BC" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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