NPI Code Detail JSON Logo

1235583790 NPI number — FULTON GI MEDICAL PLLC

NPI Number: 1235583790
Health Care Provider/Practitioner: FULTON GI MEDICAL PLLC

Information about “1235583790” NPI (FULTON GI MEDICAL PLLC) exists in 1235583790 in HTML format HTML  |  1235583790 in plain Text format TXT  |  1235583790 in PDF (Portable Document Format) PDF  |  1235583790 in an XML format XML  formats.

NPI Number : 1235583790 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1235583790",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "FULTON GI MEDICAL PLLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "3916 PRINCE ST STE 354",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "FLUSHING",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "11354-5367",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "718-316-6873",
    "MailingAddressFaxNumber": "718-316-6874",
    "FirstLinePracticeLocationAddress": "3916 PRINCE ST STE 354",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FLUSHING",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "11354-5367",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "212-431-4309",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/20/2016",
    "LastUpdateDate": "10/12/2016",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "NG",
    "AuthorizedOfficialFirstName": "ANTHONY",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "MEMBER",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "212-431-4309",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "207RG0100X",
          "TaxonomyName": "Gastroenterology Physician",
          "LicenseNumber": "196705",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RG0100X",
          "TaxonomyName": "Gastroenterology Physician",
          "LicenseNumber": "187495",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207RG0100X",
          "TaxonomyName": "Gastroenterology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
        }
      ]
    }
  }
}
                
            

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