DR. EITEL EMANUEL PROVIDENCE M.D. NPI 1215145552

NPI Information

NPI: 1215145552
Provider Name: DR. EITEL EMANUEL PROVIDENCE, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual
Address:
3311 NEWKIRK AVE
BROOKLYN, NY
ZIP 11203
Phone: (718) 284-4423
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DR. Eitel Emanuel Providence, M.D. is a specialist in Brooklyn, NY. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Eitel Emanuel Providence, M.D. NPI is 1215145552. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3311 NEWKIRK AVE
BROOKLYN, NY
ZIP 11203-108
Phone: (718) 284-4423
Fax: (718) 469-8708

The enumeration date for this NPI number is 5/18/2007 and was last updated on 7/8/2007.

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	174400000X	Specialist		155818	NEW YORK	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
1	A62576	MEDICARE UPIN	NEW YORK
2	38D041	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK
3	00877207	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: 11/14/2023

NPI Synchronization or Removal

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