1629204656 NPI number — MIERA HARRIS RECHTSCHAFFEN M.D.

Table of content: MIERA HARRIS RECHTSCHAFFEN M.D. (NPI 1629204656)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629204656 NPI number — MIERA HARRIS RECHTSCHAFFEN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RECHTSCHAFFEN
Provider First Name:
MIERA
Provider Middle Name:
HARRIS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HARRIS
Provider Other First Name:
MIERA
Provider Other Middle Name:
BETH
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1629204656
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/04/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
40 E 80TH ST # 5A
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10075-0230
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-744-2078
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
630 W 168TH ST
Provider Second Line Business Practice Location Address:
DIVISION OF PULMONARY MEDICINE PH8E-101
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10032-3725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-305-9817
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/04/2009

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: 207RP1001X , with the licence number:  236073 , 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)