1700093952 NPI number — DR. AMY I SAPODIN AUD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700093952 NPI number — DR. AMY I SAPODIN AUD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

SAPODIN

Provider First Name:

AMY

Provider Middle Name:

I

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

AUD

Provider Gender Code:

F

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:

1700093952

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

12/20/2018

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

1163 WILLIS AVENUE

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

ALBERTSON

Provider Business Mailing Address State Name:

NY

Provider Business Mailing Address Postal Code:

11507

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

516-484-0811

Provider Business Mailing Address Fax Number:

718-514-7403

Provider First Line Business Practice Location Address:

1163 WILLIS AVENUE

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:

ALBERTSON

Provider Business Practice Location Address State Name:

NY

Provider Business Practice Location Address Postal Code:

11507

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

516-484-0811

Provider Business Practice Location Address Fax Number:

516-484-2205

Provider Enumeration Date:

05/17/2007

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 231H00000X , with the licence number:  001235 1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 4901227 . This is a "GHI NETWORK ACCESS MEDICA" identifier . This identifiers is of the category "OTHER".
• Identifier: 010555483 . This is a "MAGNAHEALTH HMO MAGNACARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 2222009 . This is a "UNITED HEALTHCARE PPO SEL" identifier . This identifiers is of the category "OTHER".
• Identifier: 010555483 . This is a "MULTIPLAN INC PPO" identifier . This identifiers is of the category "OTHER".
• Identifier: 010555483 . This is a "CIGNA HEALTHCARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 204689P . This is a "HIP" identifier . This identifiers is of the category "OTHER".
• Identifier: 1024922 . This is a "AETNA US HEALTHCARE HMO" identifier . This identifiers is of the category "OTHER".
• Identifier: 136473 . This is a "VYTRA HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
• Identifier: 5657619 . This is a "AETNA US HEALTHCARE PPO P" identifier . This identifiers is of the category "OTHER".
• Identifier: M71511 . This is a "EMPIRE BLUECROSS BLUESHIE" identifier . This identifiers is of the category "OTHER".
• Identifier: 01055548301 . This is a "LOCAL 1199" identifier . This identifiers is of the category "OTHER".
• Identifier: 02162 . This is a "HEARPO" identifier . This identifiers is of the category "OTHER".
• Identifier: P2578727 . This is a "OXFORD HEALTH PLANS PPO" identifier . This identifiers is of the category "OTHER".