1417085655 NPI number — MRS. JOYLIN P PRIMUS-ARMSTRONG CRNA

Table of content: PAOLA ANDREA VARGAS RIOS COTA (NPI 1851169791)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1417085655 NPI number — MRS. JOYLIN P PRIMUS-ARMSTRONG CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PRIMUS-ARMSTRONG
Provider First Name:
JOYLIN
Provider Middle Name:
P
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

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:
1417085655
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/05/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
19 TRAILSIDE PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW CITY
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10956-1312
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
845-638-0227
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 ROUTE 59
Provider Second Line Business Practice Location Address:
SUITE 105
Provider Business Practice Location Address City Name:
SUFFERN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10901-4927
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
845-357-5770
Provider Business Practice Location Address Fax Number:
845-357-8263
Provider Enumeration Date:
03/01/2007

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: 367500000X , with the licence number:  392003 , 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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