1629098207 NPI number — SHICK YU MD

Table of content: SHICK YU MD (NPI 1629098207)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629098207 NPI number — SHICK YU MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YU
Provider First Name:
SHICK
Provider Middle Name:
Provider Name Prefix Text:
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:
1629098207
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
95 GRASSLANDS RD-NYMC
Provider Second Line Business Mailing Address:
DEPT OF MEDICINE-MUNGER PAVILION
Provider Business Mailing Address City Name:
VALHALLA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10595
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-493-8370
Provider Business Mailing Address Fax Number:
914-594-4434

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
311 NORTH ST
Provider Second Line Business Practice Location Address:
SUITE 207
Provider Business Practice Location Address City Name:
WHITE PLAINS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10605-2217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-681-0926
Provider Business Practice Location Address Fax Number:
914-681-1354
Provider Enumeration Date:
07/19/2006

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: 207R00000X , with the licence number:  207658 , 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: 01982498 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: YS7658 . This is a "ATLANTIS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 842992 . This is a "BCBS OF NY WHITE PLAINS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P1900057 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 500636 . This is a "MVP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00000051811 . This is a "GHI HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5C5581 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2302391 . This is a "AETNA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2596330 . This is a "GHI PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7844045 . This is a "AETNA PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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