1720062326 NPI number — DR. NEIL BARRY KIRSCHEN MD

Table of content: MATTHEW MURILLO (NPI 1578027819)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720062326 NPI number — DR. NEIL BARRY KIRSCHEN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KIRSCHEN
Provider First Name:
NEIL
Provider Middle Name:
BARRY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1720062326
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/16/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
77 NORTH CENTRE AVE
Provider Second Line Business Mailing Address:
SUITE 202
Provider Business Mailing Address City Name:
ROCKVILLE CENTRE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11570
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
516-764-7246
Provider Business Mailing Address Fax Number:
516-678-3525

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
77 NORTH CENTRE AVE
Provider Second Line Business Practice Location Address:
SUITE 202
Provider Business Practice Location Address City Name:
ROCKVILLE CENTRE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11570
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-764-7246
Provider Business Practice Location Address Fax Number:
516-678-3525
Provider Enumeration Date:
12/06/2005

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: 207L00000X , with the licence number:  1527711 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207LP2900X , with the licence number: 1527711 , 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)

  • Identifier: 112999600 . This is a "UNITED HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 72D781 . This is a "MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P3291435 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 112999600 . This is a "MULTIPLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 87248 . This is a "GHI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 8799819 . This is a "GHI PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: CM0035 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 118077 . This is a "VYTRA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 112999600 . This is a "MDNY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 5813851 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01631305 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 112999600 . This is a "HORIZON" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4C9360 . This is a "PHS HEALTHNET" identifier . This identifiers is of the category "OTHER".
  • Identifier: 112999600 . This is a "EMPIRE PLAN GVT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3B0261 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 112999600 . This is a "MAGNACARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: P620959 . This is a "OXFORD ALT MED" identifier . This identifiers is of the category "OTHER".




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