1619157401 NPI number — RONALD A NAGY DPM PC

Table of content: (NPI 1619157401)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619157401 NPI number — RONALD A NAGY DPM PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RONALD A NAGY DPM 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:
1619157401
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/12/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
555 N GILBERT RD
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
MESA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85203-7551
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-833-4728
Provider Business Mailing Address Fax Number:
480-898-8847

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
555 N GILBERT RD
Provider Second Line Business Practice Location Address:
SUITE 102
Provider Business Practice Location Address City Name:
MESA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85203-7551
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-833-4728
Provider Business Practice Location Address Fax Number:
480-898-8847
Provider Enumeration Date:
11/08/2007

Additional Information

Authorized Official

Authorized Official Last Name:
NAGY
Authorized Official First Name:
RONALD
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
480-833-4728

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X , with the licence number:  0237 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0795640001 . This is a "MEDICARE DME P10" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: Z20376 . This is a "MEDICARE" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".




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