NEW BERLIN FAMILY PRACTICE NPI 1003869066

NPI Information

NPI: 1003869066
Provider Name: NEW BERLIN FAMILY PRACTICE
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
4 TERRACE HTS
NEW BERLIN, NY
ZIP 13411
Phone: (607) 847-6750
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NEW BERLIN FAMILY PRACTICE is a family nurse practitioner in New Berlin, NY. NEW BERLIN FAMILY PRACTICE NPI is 1003869066. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4 TERRACE HTS
NEW BERLIN, NY
ZIP 13411-514
Phone: (607) 847-6750

The provider's authorized official is Roger J. Halbert .
The authorized official title is Ceo and has the following contact phone number (607) 847-7000.

The enumeration date for this NPI number is 5/18/2006 and was last updated on 8/22/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	02160938	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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