STEPHEN JAMES CZACHOR - NPI NUMBER 1699078584

Summary

Provider Name: STEPHEN JAMES CZACHOR

NPI Number: 1699078584

Clasification: Licensed Practical Nurse (164W00000X)

Address:
4 NORFOLK CT
CORAM, NY
ZIP 11727

Phone Number: (631) 949-0799



Detailed Information

Stephen James Czachor is a licensed practical nurse in Coram, NY. The provider is an individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. The assigned NPI number for this provider is 1699078584 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business address is:

4 NORFOLK CT
CORAM, NY
ZIP 11727-636
Phone: (631) 949-0799

The enumeration date for this NPI number is 12/15/2010 and was last updated on 12/15/2010.

Map - Location of Practice

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Taxonomy Codes

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 164W00000X Licensed Practical Nurse 303741 NY Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1699078584 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name CZACHOR The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name STEPHEN The first name of the provider, if the provider is an individual.
5 Provider Middle Name JAMES The middle name of the provider, if the provider is an individual.
6 Provider First Line Business Practice Location Address 4 NORFOLK CT The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
7 Provider Business Practice Location Address City Name CORAM The city name in the location address of the provider being identified.
8 Provider Business Practice Location Address State Name NY The State code in the location of the provider being identified.
9 Provider Business Practice Location Address Postal Code 117271636 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
10 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
11 Provider Business Practice Location Address Telephone Number 6319490799 The telephone number associated with the location address of the provider being identified.
12 Provider Enumeration Date 12/15/2010 The date the provider was assigned a unique identifier (assigned an NPI).
13 Last Update Date 12/15/2010 The date that a record was last updated or changed.
14 Provider Gender Code M The code designating the provider’s gender if the provider is a person.
15 Healthcare Provider Taxonomy Code 1 164W00000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
16 Provider License Number 1 303741 The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
17 Provider License Number State Code 1 NY The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
18 Healthcare Provider Primary Taxonomy Switch 1 Y
19 Is Sole Proprietor N Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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