1528228822 NPI number — DR. KATHRYN MARGARET DUPNIK MD

Table of content: DR. KATHRYN MARGARET DUPNIK MD (NPI 1528228822)

General
Organization/Personal Information
Provider's Other Name Information
NPI Number Information
Provider's Business Mailing Address
Provider's Practice Location Mailing Address
Additional Information
Authorized Official
Provider Taxonomy Codes
Other Provider's Identifiers (legacy, non-NPI)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528228822 NPI number — DR. KATHRYN MARGARET DUPNIK MD

Organization/Personal Information

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:
DUPNIK

Provider First Name:
KATHRYN

Provider Middle Name:
MARGARET

Provider Name Prefix Text:
DR.

Provider Name Suffix Text:

Provider Credential Text:
MD

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:
1528228822

Entity Type Code:
Individual

Replacement NPI:

Last Update Date:
07/19/2023

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
630 WEST 168 STREET

Provider Second Line Business Mailing Address:
BOX 4

Provider Business Mailing Address City Name:
NEW YORK

Provider Business Mailing Address State Name:
NY

Provider Business Mailing Address Postal Code:
10032-3725

Provider Business Mailing Address Country Code:
US

Provider Business Mailing Address Telephone Number:

Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1305 YORK AVE FL 4

Provider Second Line Business Practice Location Address:

Provider Business Practice Location Address City Name:
NEW YORK

Provider Business Practice Location Address State Name:
NY

Provider Business Practice Location Address Postal Code:
10021

Provider Business Practice Location Address Country Code:
US

Provider Business Practice Location Address Telephone Number:
646-962-8747

Provider Business Practice Location Address Fax Number:
646-962-0152

Provider Enumeration Date:
06/11/2008

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Taxonomy code: 207RI0200X , with the licence number: 248603 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .