1891827663 NPI number — ADVANCED ENT PHYSICIANS & SURGEONS OF CNY PC

Table of content: ANDRES FELIPE ORJUELA M.D. (NPI 1588687933)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1891827663 NPI number — ADVANCED ENT PHYSICIANS & SURGEONS OF CNY PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED ENT PHYSICIANS & SURGEONS OF CNY 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:
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:
1891827663
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/13/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5700 W GENESEE ST
Provider Second Line Business Mailing Address:
SUITE 229
Provider Business Mailing Address City Name:
CAMILLUS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13031-3200
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-234-9865
Provider Business Mailing Address Fax Number:
315-234-9858

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5700 W GENESEE ST
Provider Second Line Business Practice Location Address:
SUITE 229
Provider Business Practice Location Address City Name:
CAMILLUS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13031-3200
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-234-9865
Provider Business Practice Location Address Fax Number:
315-234-9858
Provider Enumeration Date:
03/09/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WALKER
Authorized Official First Name:
LOREEN
Authorized Official Middle Name:
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
315-234-9865

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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