NPI Code Detail JSON Logo

1619513157 NPI number — PREMIER PAIN CARE & WELLNESS INC

NPI Number: 1619513157
Health Care Provider/Practitioner: PREMIER PAIN CARE & WELLNESS INC

Information about “1619513157” NPI (PREMIER PAIN CARE & WELLNESS INC) exists in 1619513157 in HTML format HTML  |  1619513157 in plain Text format TXT  |  1619513157 in PDF (Portable Document Format) PDF  |  1619513157 in an XML format XML  formats.

NPI Number : 1619513157 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1619513157",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PREMIER PAIN CARE & WELLNESS INC",
    "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": "40 CROSS ST STE 301",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "NORWALK",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06851-4647",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "40 CROSS ST STE 301",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "NORWALK",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06851-4647",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "203-956-0022",
    "PracticeLocationAddressFaxNumber": "203-956-0024",
    "EnumerationDate": "11/19/2019",
    "LastUpdateDate": "06/12/2020",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "ECHEZONA",
    "AuthorizedOfficialFirstName": "GENDAI",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "PROVIDER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "MD",
    "AuthorizedOfficialTelephoneNumber": "914-469-7877",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "208VP0000X",
          "TaxonomyName": "Pain Medicine Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "207L00000X",
          "TaxonomyName": "Anesthesiology Physician",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": [
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        },
        {
          "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
          "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
        }
      ]
    }
  }
}
                
            

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