DR. PROSPERO CENTENO SANIDAD M.D., NPI 1134406424 — NEW YORK (NY)

NPI 1134406424

8+ Years Experience Individual

DR. PROSPERO CENTENO SANIDAD M.D.

11/15/2011
PROVIDER ENUMERATION DATE
11/15/2011
LAST UPDATE DATE
1134406424
NPI NUMBER

About DR. PROSPERO CENTENO SANIDAD

Sole proprietor? Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor.

DR. PROSPERO CENTENO SANIDAD is a provider established in NEW YORK, NY. The NPI number of DR. PROSPERO CENTENO SANIDAD is 1134406424 and was assigned on 11/15/2011. The practitioners primary taxonomy code is: 208D00000X with license number: 91297 NY .

Mailing address

  • City: NY
  • State: NY
  • Postal code: 10019
  • Phone: 2125828075
  • Address: 330 W 58TH ST 8C

Primary Practice Address

  • Region : NEW YORK, NY
  • NPI : 1134406424
  • Phone : 2125828075
  • Postalcode : 10019
  • Address : 330 W 58TH ST 8C

Provider taxonomy - General Practice

  • Taxonomy code: 208D00000X
  • License number: 91297
  • License state: NY

The taxonomy is the primary taxonomy (there can be only one per NPI record).

Contacts:

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  • DR. PROSPERO CENTENO SANIDAD M.D.
  • Address : 330 W 58TH ST 8C
  • Region : NEW YORK, NY
  • NPI : 1134406424
  • Phone : 2125828075
  • Postalcode : 10019

Reference NPI Information. Full replica of the CMS (NPPES) NPI record

Field Name Value
Provider First Line Business Practice Location Address330 W 58TH ST 8C
The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Provider Business Practice Location Address City NameNEW YORK
The city name in the location address of the provider being identified.
Provider Business Practice Location Address State NameNY
The State or Province name in the location address of the provider being identified.
Provider Business Practice Location Address Postal Code10019
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Telephone Number2125828075
The telephone number associated with the location address of the provider being identified.
NPI1134406424
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1208D00000X
Provider Enumeration Date11/15/2011
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated11/15/2011
The date that a record was last updated or changed.
Entity TypeIndividual
Code describing the type of health care provider that is being assigned an NPI. Codes are:
  • 1 = (Person): individual human being who furnishes health care;
  • 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Provider Organization Name (Legal Business Name)DR. PROSPERO CENTENO SANIDAD
Provide organization name (legal business name used to file tax returns with the IRS). The Organization Name field allows the following special characters: ampersand, apostrophe, "at" sign, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters.
Provider First Line Business Mailing Address330 W 58TH ST 8C
The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
Provider Business Mailing Address City NameNY
The City name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address City name".
Provider Business Mailing Address State NameNY
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
Provider Business Mailing Address Postal Code10019
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
Provider Business Mailing Address Telephone Number2125828075
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
Healthcare Provider Taxonomy Code #1208D00000X
The Health Care Provider Taxonomy code is a unique alphanumeric code, ten characters in length. The code set is structured into three distinct "Levels" including Provider Type, Classification, and Area of Specialization.
Healthcare Provider Taxonomy 1General Practice
Provider License Number 191297
Certain taxonomy selections will require you to enter your license number and the state where the license was issued. Select Foreign Country in the state drop down box if the license was issued outside of United States. The License Number field allows the following special characters: ampersand, apostrophe, colon, comma, forward slash, hyphen, left and right parentheses, period, pound sign, quotation mark, and semi-colon. A field cannot contain all special characters. DO NOT report the Social Security Number (SSN), IRS Individual Taxpayer Identification Number (ITIN) in this section.
Provider License Number State Code 1NY
Healthcare Provider Primary Taxonomy Switch 1Y
Primary Taxonomy:
  • X - The primary taxonomy switch is Not Answered;
  • Y - The taxonomy is the primary taxonomy (there can be only one per NPI record);
  • N - The taxonomy is not the primary taxonomy.
Provider Gender CodeM
  • M - male
  • F - female
Is sole proprietorY
  • X - Not Answered
  • Y - Yes, Entity Type 1 Provider (Individual) is a Sole Proprietor
  • N - No, Entity Type 1 Provider (Individual) is not a Sole Proprietor
X

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