1942504196 NPI number — YOSHIHARU AKABANE PC

Table of content: (NPI 1942504196)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942504196 NPI number — YOSHIHARU AKABANE PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YOSHIHARU AKABANE 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:
1942504196
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/03/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
330 LYNNWAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LYNN
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01901-1706
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-593-6451
Provider Business Mailing Address Fax Number:
781-593-0071

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
330 LYNNWAY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LYNN
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01901-1706
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
781-593-6451
Provider Business Practice Location Address Fax Number:
781-593-0071
Provider Enumeration Date:
01/03/2011

Additional Information

Authorized Official

Authorized Official Last Name:
AKABANE
Authorized Official First Name:
YOSHIHARU
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
781-595-6764

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  40233 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1004500 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 043101892 . This is a "HARVARD PILGRIM HEALTHCARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 043101892 . This is a "PACIFIC CARE" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 1004500 . This is a "FALLON COMMUNITY HEALTH PLAN" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 992932 . This is a "NETEORK HEALTH" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 000134 . This is a "HP/VAL.OPT" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 120002 . This is a "BC/BS OF MASS (HMO)" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 0139017 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 120002 . This is a "BLUE CROSS/BLUE SHIELD (INDEMITY)" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 709709 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 12000AK . This is a "MEDICARE ID UNSPECIFIED" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 206283 . This is a "MC" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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