National Provider Identifier (Npi) Form: Section 1 - Basic Information

You might also like

Download as pdf or txt
Download as pdf or txt
You are on page 1of 1

WWW.HIPAASPACE.

COM
NATIONAL PROVIDER IDENTIFIER (NPI) FORM

HIPAASpace NPI Form Source NPI Lookup

Information provided in the current document is obtained from official source and accuracy of the information provided is the sole responsibility of the healthcare provide. All changes, corrections or updates must be done through the official sources. Please contact HIPAASpace.com in case you need the assistance in obtaining the official contacts of corresponding government organizations.

SECTION 1 BASIC INFORMATION


NPI Number Provider (Organization) Full Name Provider (Organization) Other Name Entity Type Replacement NPI

1922335819
Gender

DR. CALABRO JANINE DVM


Last Update Date Deactivation Reason Code Deactivation Date Reactivation Date

Individual
Employer Identification Number (EIN)

Enumeration Date

Female

11/12/2009

11/12/2009

SECTION 2 CONTACT INFORMATION


Business Mailing Address

510 E 62ND ST ANIMAL MEDICAL CENTER, NEW YORK NY10065-8314 US


Practice Location Address

510 E 62ND ST ANIMAL MEDICAL CENTER, NEW YORK NY10065-8314 US


Business Phone Number Business Fax Number Practice Phone Number Practice Fax Number

212-329-8755
Authorized Official Name

212-329-8755
Authorized Official Title/Position Authorized Official - Phone Number

SECTION 3 LICENSING, IDENTIFICATION INFORMATION


A. TAXONOMY INFORMATION 1. Code: 174M00000X (Veterinarian). License Number : 010886 NY.

B. OTHER PROVIDER IDENTIFIERS

www.hipaaspace.com

NPI Profile: 1922335819 DR. CALABRO JANINE DVM

You might also like