1952614455 NPI number — YMB SURGERY P.L.L.C.

Table of content: KAVYA BHIKHABHAI PATEL M.D. (NPI 1639554538)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952614455 NPI number — YMB SURGERY P.L.L.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YMB SURGERY P.L.L.C.
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:
1952614455
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10845 PHILADELPHIA RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITE MARSH
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21162-1717
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-335-0008
Provider Business Mailing Address Fax Number:
410-335-3113

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
44084 RIVERSIDE PKWY
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
LANSDOWNE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
20176-5102
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-687-3158
Provider Business Practice Location Address Fax Number:
703-687-3166
Provider Enumeration Date:
07/26/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BARAKI
Authorized Official First Name:
YAQUB
Authorized Official Middle Name:
M.
Authorized Official Title or Position:
SOLE MANAGER
Authorized Official Telephone Number:
818-970-4497

Provider Taxonomy Codes

  • Taxonomy code: 208600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: CB4QY . This is a "CAREFIRST" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: E050 . This is a "MEDICARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 510466100 . This is a "MEDICAL ASSISTANCE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 198107 . This is a "MEDICARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 227971 . This is a "MEDICARE" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: X739 . This is a "CAREFIRST" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".




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