1831457019 NPI number — MEERA PRABHAT PHYSICIAN P.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831457019 NPI number — MEERA PRABHAT PHYSICIAN P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEERA PRABHAT PHYSICIAN P.C.
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:
MEERA PRABHAT
Provider Other Organization Name Type Code:
4
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:
1831457019
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/25/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
14416 HOLLY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FLUSHING
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11355-2244
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-445-8994
Provider Business Mailing Address Fax Number:
718-445-9035

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14416 HOLLY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FLUSHING
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11355-2244
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-445-8994
Provider Business Practice Location Address Fax Number:
718-445-9035
Provider Enumeration Date:
04/25/2012

Additional Information

Authorized Official

Authorized Official Last Name:
PRABHAT
Authorized Official First Name:
MEERA
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
718-445-8994

Provider Taxonomy Codes

  • Taxonomy code: 261QP2300X , with the licence number:  115635 , 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)





Copyright © 2007-2024 www.npivalidator.com