1720652829 NPI number — PROMPT INTERVENTIONAL SERVICES, INC.

Table of content: JOHN MICHAEL GENTILE RN (NPI 1023636701)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720652829 NPI number — PROMPT INTERVENTIONAL SERVICES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PROMPT INTERVENTIONAL SERVICES, INC.
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:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
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Provider Other Credential Text:
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NPI Number Information

NPI Number:
1720652829
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/14/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
155 OCEANA DR E APT 3G
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11235-6684
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
917-402-7149
Provider Business Mailing Address Fax Number:
718-878-4537

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
155 OCEANA DR E APT 3G
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11235-6684
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
917-402-7149
Provider Business Practice Location Address Fax Number:
718-878-4537
Provider Enumeration Date:
05/14/2021

Additional Information

Authorized Official

Authorized Official Last Name:
KHAMISH
Authorized Official First Name:
ELINA
Authorized Official Middle Name:
Authorized Official Title or Position:
SPECIAL EDUCATION SPECIALIST
Authorized Official Telephone Number:
917-402-7149

Provider Taxonomy Codes

  • Taxonomy code: 252Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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