1689895435 NPI number — P R HEMATOLOGY ONCOLOGY GROUP INC

Table of content: (NPI 1689895435)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689895435 NPI number — P R HEMATOLOGY ONCOLOGY GROUP INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
P R HEMATOLOGY ONCOLOGY GROUP INC
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:
1689895435
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 PASEO SAN PABLO
Provider Second Line Business Mailing Address:
ARTURO CADILLA SUITE 511
Provider Business Mailing Address City Name:
BAYAMON
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00961-7019
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-780-2830
Provider Business Mailing Address Fax Number:
787-786-8281

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 PASEO SAN PABLO
Provider Second Line Business Practice Location Address:
ARTURO CADILLA SUITE 511
Provider Business Practice Location Address City Name:
BAYAMON
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00961-7019
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-780-2830
Provider Business Practice Location Address Fax Number:
787-786-8281
Provider Enumeration Date:
05/01/2007

Additional Information

Authorized Official

Authorized Official Last Name:
AGRAIT
Authorized Official First Name:
INGRID
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
787-780-2830

Provider Taxonomy Codes

  • Taxonomy code: 261QX0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 12565 . This is a "SSS" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com