1750321626 NPI number — JEFFREY R MAYER MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750321626 NPI number — JEFFREY R MAYER MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

MAYER

Provider First Name:

JEFFREY

Provider Middle Name:

R

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

M

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:

1750321626

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

05/02/2008

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

400 EAST MAIN STREET

Provider Second Line Business Mailing Address:

NORTHERN WESTCHESTER HOSPITAL ATTN: MEDICAL AFFAIRS OFF

Provider Business Mailing Address City Name:

MT KISCO

Provider Business Mailing Address State Name:

NY

Provider Business Mailing Address Postal Code:

10549

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

914-666-1254

Provider Business Mailing Address Fax Number:

914-666-1965

Provider First Line Business Practice Location Address:

400 EAST MAIN STREET

Provider Second Line Business Practice Location Address:

NORTHERN WESTCHESTER HOSPITAL EMERGENCY ROOM

Provider Business Practice Location Address City Name:

MT KISCO

Provider Business Practice Location Address State Name:

NY

Provider Business Practice Location Address Postal Code:

10549

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

914-666-1254

Provider Business Practice Location Address Fax Number:

914-666-1931

Provider Enumeration Date:

06/07/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207P00000X , with the licence number:  217698 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 000000106123 . This is a "GHI HMO PIN#" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 060707000001 . This is a "FIDELIS CARE OF NY PIN #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 1082049 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
• Identifier: 2288Q1 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
• Identifier: 2154190 . This is a "UNITED HEALTHCARE PIN #" identifier . This identifiers is of the category "OTHER".
• Identifier: 4147739 . This is a "MVP" identifier . This identifiers is of the category "OTHER".
• Identifier: P3650590 . This is a "OXFORD HEALTH PLAN PIN #" identifier . This identifiers is of the category "OTHER".
• Identifier: 10087294 . This is a "CDPHP PIN#" identifier . This identifiers is of the category "OTHER".
• Identifier: 1082049 . This is a "AETNA HMO PIN #" identifier . This identifiers is of the category "OTHER".
• Identifier: 7033196 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
• Identifier: 0112699 . This is a "GHI PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
• Identifier: 5C4627 . This is a "HEALTHNET PIN #" identifier . This identifiers is of the category "OTHER".