Healthcare Provider Details

I. General information

NPI: 1346227519
Provider Name (Legal Business Name): HOWARD ARCINIEGAS ATC
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 12/28/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

361 ROUTE 59
SPRING VALLEY NY
10977-5252
US

IV. Provider business mailing address

85 W SNEDEN PL
SPRING VALLEY NY
10977-3910
US

V. Phone/Fax

Practice location:
  • Phone: 845-577-6573
  • Fax:
Mailing address:
  • Phone: 845-356-6202
  • Fax: 845-426-0286

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number000535-1
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: