1700047602 NPI number — ADRAENNE BOWE NURSE PRACTITIONER

Table of content: ADRAENNE BOWE NURSE PRACTITIONER (NPI 1700047602)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700047602 NPI number — ADRAENNE BOWE NURSE PRACTITIONER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOWE
Provider First Name:
ADRAENNE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NURSE PRACTITIONER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BERNSTEIN
Provider Other First Name:
ADRAENNE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
NURSE PRACTITIONER
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1700047602
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 TIME WARNER CTR
Provider Second Line Business Mailing Address:
10TH FLR., ROOM 10-140
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10019-6038
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-484-6912
Provider Business Mailing Address Fax Number:
212-484-7269

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 TIME WARNER CTR
Provider Second Line Business Practice Location Address:
10TH FLR., ROOM 10-140
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10019-6038
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-484-6912
Provider Business Practice Location Address Fax Number:
212-484-7269
Provider Enumeration Date:
06/23/2008

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: 363LF0000X , with the licence number:  F333961-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LP0200X , with the licence number: F380388-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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