1629117296 NPI number — MR. STEVEN M ASOFSKY M.A.

Table of content: MR. STEVEN M ASOFSKY M.A. (NPI 1629117296)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629117296 NPI number — MR. STEVEN M ASOFSKY M.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ASOFSKY
Provider First Name:
STEVEN
Provider Middle Name:
M
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
M.A.
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:
1629117296
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/18/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
400 MONTAUK HWY
Provider Second Line Business Mailing Address:
STE 152
Provider Business Mailing Address City Name:
BABYLON
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11702-3009
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-665-9168
Provider Business Mailing Address Fax Number:
631-665-9179

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
400 W MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BABYLON
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11702-3012
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-669-7098
Provider Business Practice Location Address Fax Number:
631-669-3736
Provider Enumeration Date:
02/06/2007

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: 235Z00000X , with the licence number:  008483-1 , 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: 7320196 . This is a "AETNA PPO #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: AZ00870 . This is a "MDNY PROVIDER #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 91990 . This is a "VYTRA ID" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4999952 . This is a "GHI PROVIDER #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 8953776001 . This is a "CIGNA PROVIDER #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2462650 . This is a "AETNA HMO #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: M10931 . This is a "BLUE CROSS ID#" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 20318P . This is a "HIP ID#" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P2128236 . This is a "OXFORD PIN #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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