S. ADIMOOLAM PHYSICIAN PC NPI 1861561441

NPI Information

NPI: 1861561441
Provider Name: S. ADIMOOLAM, PHYSICIAN, PC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1756 RICHMOND AVE
STATEN ISLAND, NY
ZIP 10314
Phone: (718) 494-3383
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S. ADIMOOLAM, PHYSICIAN, PC is a specialist in Staten Island, NY. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. S. ADIMOOLAM, PHYSICIAN, PC NPI is 1861561441. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1756 RICHMOND AVE
STATEN ISLAND, NY
ZIP 10314-902
Phone: (718) 494-3383
Fax: (718) 494-1705

The provider's authorized official is Debra Prucha .
The authorized official title is Office Manager and has the following contact phone number (718) 494-4934.

The enumeration date for this NPI number is 11/7/2006 and was last updated on 8/18/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	174400000X	Specialist		NYS121313	NEW YORK	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	00440597	MEDICAID	NEW YORK
2	25A411	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK
3	OC1723	OTHER	NEW YORK	PHC
4	0019584	OTHER	NEW YORK	GROUP HEALTH INSURANCE
5	25A413	MEDICARE ID-TYPE UNSPECIFIED	NEW YORK
6	OS053	OTHER	NEW YORK	OXFORD HEALTH PLANS
7	B11536	MEDICARE UPIN	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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