1619957255 NPI number — WESTCHESTER-PUTNAM ALLERGY & ASTHMA CARE P.C.

Table of content: (NPI 1619957255)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619957255 NPI number — WESTCHESTER-PUTNAM ALLERGY & ASTHMA CARE P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WESTCHESTER-PUTNAM ALLERGY & ASTHMA CARE P.C.
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:
1619957255
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 556
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILLWOOD
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10546-0556
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-241-0567
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
341 ROUTE 312
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BREWSTER
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10509-2328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-278-0772
Provider Business Practice Location Address Fax Number:
845-278-0794
Provider Enumeration Date:
01/19/2006

Additional Information

Authorized Official

Authorized Official Last Name:
NARASIMHAN
Authorized Official First Name:
VIDYA
Authorized Official Middle Name:
Authorized Official Title or Position:
PROFESSIONAL CORPORATION
Authorized Official Telephone Number:
914-241-0567

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  198281 , 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: 01654640 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2041011 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2099739 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 037411 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0D3240 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 95G551 . This is a "BLUE CROSS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1427342 . This is a "UHC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P406000 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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