1104968692 NPI number — AREBA CASRIEL INC.

Table of content: (NPI 1245216399)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1104968692 NPI number — AREBA CASRIEL INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AREBA CASRIEL 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:
6
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:
1104968692
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/13/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
850 COLUMBUS AVENUE
Provider Second Line Business Mailing Address:
APT 2C
Provider Business Mailing Address City Name:
NYC
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10025
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-241-2063
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
850 COLUMBUS AVE
Provider Second Line Business Practice Location Address:
APT 2C
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10025-4560
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-241-2063
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
RITA
Authorized Official First Name:
ANGELA
Authorized Official Middle Name:
Authorized Official Title or Position:
CLINICAL DIRECTOR
Authorized Official Telephone Number:
212-293-3000

Provider Taxonomy Codes

  • Taxonomy code: 251S00000X , with the licence number:  070978-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 324500000X , with the licence number: 070978-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 070978-1 . This is a "LICENSED CLINICAL SOCIAL" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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