1881617504 NPI number — GEORGE MAGUIRE MD

Table of content: GEORGE MAGUIRE MD (NPI 1881617504)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881617504 NPI number — GEORGE MAGUIRE MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAGUIRE
Provider First Name:
GEORGE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1881617504
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/29/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
95 GRASSLANDS RD-NYMC
Provider Second Line Business Mailing Address:
DEPT OF MEDICINE
Provider Business Mailing Address City Name:
VALHALLA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10595
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-493-7517
Provider Business Mailing Address Fax Number:
914-594-4434

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
95 GRASSLANDS RD-NYMC
Provider Second Line Business Practice Location Address:
DEPT OF MEDICINE-MACY PAVILION
Provider Business Practice Location Address City Name:
VALHALLA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10595
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-493-7517
Provider Business Practice Location Address Fax Number:
914-594-4434
Provider Enumeration Date:
07/25/2006

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: 207RC0200X , with the licence number:  117119 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RP1001X , with the licence number: 117119 , 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: 696496 . This is a "MVP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0007490 . This is a "GHI PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00421889 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 117119-8W . This is a "WORKERS COMPENSATION" identifier . This identifiers is of the category "OTHER".
  • Identifier: 118325 . This is a "WELLCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4318604 . This is a "AETNA PPO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 5C6272 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 00000018325 . This is a "GHI HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 117119 . This is a "HIP" identifier . This identifiers is of the category "OTHER".
  • Identifier: WS426 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 310AD1 . This is a "BCBS OF NY HAWTHORNE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 01A081 . This is a "BCBS OF NY VALHALLA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 003203 . This is a "CONNECTICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0533016 . This is a "AETNA HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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