1699270256 NPI number — IZZY HEALTH, PLLC VINCENT IZEDIUNO MD, MRCPsych PSYCHIATRY

Table of content: VINCENT IZEDIUNO MD, MRCPsych PSYCHIATRY (NPI 1699270256)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699270256 NPI number — IZZY HEALTH, PLLC VINCENT IZEDIUNO MD, MRCPsych PSYCHIATRY

Organization/Personal Information

Employer Identification Number (EIN):
N/A
Provider Organization Name:
IZZY HEALTH, PLLC
Provider Last Name:
IZEDIUNO
Provider First Name:
VINCENT
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
MD, MRCPsych
Provider Credential Text:
PSYCHIATRY
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:
1699270256
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/27/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
600 Green Valley Road
Provider Second Line Business Mailing Address:
Suite 208
Provider Business Mailing Address City Name:
Greensboro
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27408
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
3365498334
Provider Business Mailing Address Fax Number:
3368601981

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
600 Green Valley
Provider Second Line Business Practice Location Address:
Suite 208
Provider Business Practice Location Address City Name:
Greensboro
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27408
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
3365498334
Provider Business Practice Location Address Fax Number:
3368601981
Provider Enumeration Date:
03/27/2018

Additional Information

Authorized Official

Authorized Official Last Name:
IZEDIUNO
Authorized Official First Name:
VINCENT
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
216-326-5700

Provider Taxonomy Codes

  • Taxonomy code: 2084P0800X , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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