1700839784 NPI number — DAVID A.N. SIEGEL, MD PC

Table of content: (NPI 1700839784)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1700839784 NPI number — DAVID A.N. SIEGEL, MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DAVID A.N. SIEGEL, MD PC
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:
6
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:
1700839784
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
393 W END AVE
Provider Second Line Business Mailing Address:
APT 11F
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10024-6138
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-321-6249
Provider Business Mailing Address Fax Number:
917-493-2078

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
271 W 125TH ST
Provider Second Line Business Practice Location Address:
STE 211
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10027-4424
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-493-9600
Provider Business Practice Location Address Fax Number:
917-493-2078
Provider Enumeration Date:
05/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SIEGEL
Authorized Official First Name:
DAVID
Authorized Official Middle Name:
A.N.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
917-493-9600

Provider Taxonomy Codes

  • Taxonomy code: 2081P2900X , with the licence number:  217196 , 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)

  • Identifier: 2799102 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 1000037102 . This is a "AFFINITY HEALTH PLANS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 4C9164 . This is a "HEALTNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P3611255 . This is a "OXFORD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 3971993 . This is a "AENTA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 7982471 . This is a "AETNA PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 9384662 . This is a "PHCS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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