1043269723 NPI number — ADVANCED MULTIMEDIA DEVICES INC

Table of content: (NPI 1043269723)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043269723 NPI number — ADVANCED MULTIMEDIA DEVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADVANCED MULTIMEDIA DEVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043269723
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/04/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
95 SHERWOOD AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FARMINGDALE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11735-1717
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-531-8888
Provider Business Mailing Address Fax Number:
631-531-8811

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
95 SHERWOOD AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FARMINGDALE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11735-1717
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-531-8888
Provider Business Practice Location Address Fax Number:
631-531-8811
Provider Enumeration Date:
05/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TANG
Authorized Official First Name:
SOMCHAL
Authorized Official Middle Name:
S
Authorized Official Title or Position:
PRES AND CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
631-531-8888

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1160083 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 200497400A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 000267400 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 003119311 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1000036135 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 161570000 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 807480 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 90006578 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0583435 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 08887244 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 806676400 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: 009947225 , issued by the state of ( AL ) . This identifiers is of the category "MEDICAID".
  • Identifier: 10025029200 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 100644620B , issued by the state of ( KS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 923124200 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 4542060 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0561833 , issued by the state of ( MT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 626095004 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".




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