1942432810 NPI number — PAIGE MARIE MCINTYRE FNP

Table of content: PAIGE MARIE MCINTYRE FNP (NPI 1942432810)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942432810 NPI number — PAIGE MARIE MCINTYRE FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCINTYRE
Provider First Name:
PAIGE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCINTYRE
Provider Other First Name:
PAIGE
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1942432810
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/01/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
31 INTERLAKEN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EASTCHESTER
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10709-1529
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-632-3445
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
171 WHITE PLAINS RD
Provider Second Line Business Practice Location Address:
CONCORDIA COLLEGE HEALTH CENTER
Provider Business Practice Location Address City Name:
BRONXVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10708-1923
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-337-9300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/11/2009

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: 363LF0000X , with the licence number:  331345 , 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)