1871793992 NPI number — NEW YORK OTOLARYNGOLOGY & AESTHETIC SURGERY PC

Table of content: (NPI 1871793992)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871793992 NPI number — NEW YORK OTOLARYNGOLOGY & AESTHETIC SURGERY PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NEW YORK OTOLARYNGOLOGY & AESTHETIC SURGERY PC
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:
6
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:
1871793992
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/29/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 230207
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:
11223-0207
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-249-9383
Provider Business Mailing Address Fax Number:
718-645-1333

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1783 W 6TH ST
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:
11223-1321
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-645-2555
Provider Business Practice Location Address Fax Number:
718-645-1333
Provider Enumeration Date:
07/18/2007

Additional Information

Authorized Official

Authorized Official Last Name:
BHAYANI
Authorized Official First Name:
RAJENDRA
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
718-249-9383

Provider Taxonomy Codes

  • Taxonomy code: 207YX0905X , with the licence number:  226427 , 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 © 2007-2025 www.npivalidator.com