1245649359 NPI number — ARTUR GOSTURANI M.D.

Table of content: ARTUR GOSTURANI M.D. (NPI 1245649359)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245649359 NPI number — ARTUR GOSTURANI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOSTURANI
Provider First Name:
ARTUR
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1245649359
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/28/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ADVANTAGECARE PHYSICIANS, PC
Provider Second Line Business Mailing Address:
55 WATER STREET 2ND FLOOR CRED DEPT
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10041-0004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
646-680-2888
Provider Business Mailing Address Fax Number:
800-871-1370

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1991 MARCUS AVE
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
NEW HYDE PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11042-2057
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
516-354-1600
Provider Business Practice Location Address Fax Number:
516-941-4677
Provider Enumeration Date:
08/04/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207V00000X , with the licence number:  25MA09538100 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207V00000X , with the licence number: 000000000000 , 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)





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