1851465793 NPI number — DR. BRUCE WAYNE LASHLEY D.P.M.

Table of content: DR. BRUCE WAYNE LASHLEY D.P.M. (NPI 1851465793)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851465793 NPI number — DR. BRUCE WAYNE LASHLEY D.P.M.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LASHLEY
Provider First Name:
BRUCE
Provider Middle Name:
WAYNE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.P.M.
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:
1851465793
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/30/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
44 E 12TH ST APT MD4
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10003-4667
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-949-2901
Provider Business Mailing Address Fax Number:
212-949-1914

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
44 E 12TH ST APT MD4
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10003-4667
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-949-2901
Provider Business Practice Location Address Fax Number:
212-949-1914
Provider Enumeration Date:
11/20/2006

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: 213E00000X , with the licence number:  N003313 , 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: 0056972 . This is a "GHI" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133435602 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 51859P . This is a "HIP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 71634 . This is a "AETNA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 48814900001 . This is a "DME DEMARC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 133435602 . This is a "1199 FUND" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: BLOP347810 . This is a "EMPIRE BC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: NS013 . This is a "OXFORD #" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: N003313C20 . This is a "HEALTHFIRST" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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