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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NPI Details

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
1174400000XSpecialist155818NEW YORKYes

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
1A62576MEDICARE UPINNEW YORK
238D041MEDICARE ID-TYPE UNSPECIFIEDNEW YORK
300877207MEDICAIDNEW 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: 11/21/2025

NPI Synchronization or Removal

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