EDUARDO SANTOS DEL ROSARIO FNP, NPI 1306868815 — NEW YORK (NY)

NPI 1306868815

13+ Years Experience Individual

EDUARDO SANTOS DEL ROSARIO FNP

07/24/2006
PROVIDER ENUMERATION DATE
05.09.2013
LAST UPDATE DATE
1306868815
NPI NUMBER

About EDUARDO SANTOS DEL ROSARIO

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

EDUARDO SANTOS DEL ROSARIO is a provider established in NEW YORK, NY. The NPI number of EDUARDO SANTOS DEL ROSARIO is 1306868815 and was assigned on 07/24/2006. The practitioners primary taxonomy code is: 363LP0200X with license number: 099007864N1 OR .

Mailing address

  • City: PHILADELPHIA
  • State: PA
  • Postal code: 191952435
  • Phone: 2128448932
  • Fax: 2128446962
  • Address: PO BOX 95000-2435

Primary Practice Address

  • Region : NEW YORK, NY
  • NPI : 1306868815
  • Phone : 2128448930
  • Fax : 2128441503
  • Postalcode : 10003
  • Address : FIRST AVENUE AT 16TH STREET

Additional identifiers

  • Identifier: 290830
  • Code / Type : 5 - MEDICAID
  • Identifier state : OR

Additional identifier(s) currently or formerly used as an identifier for the provider. The codes may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Additional identifiers # 2

  • Identifier: 208VP0014X
  • Code / Type : 1 - other
  • Identifier state : NY
  • Identifier issuer : DPMPC

Provider taxonomy - Nurse Practitioner

  • Taxonomy code: 363LP0200X
  • License number: 099007864N1
  • License state: OR

The taxonomy is not the primary taxonomy.

Healthcare provider taxonomy #2 - Nurse Practitioner

  • Taxonomy code: 363LF0000X
  • License number: 336714
  • License state: OR

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

Contacts:

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  • EDUARDO SANTOS DEL ROSARIO FNP
  • Address : FIRST AVENUE AT 16TH STREET
  • Region : NEW YORK, NY
  • NPI : 1306868815
  • Phone : 2128448930
  • Fax : 2128441503
  • Postalcode : 10003

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

Field Name Value
Provider First Line Business Practice Location AddressFIRST AVENUE AT 16TH STREET
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 Code10003
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 Number2128448930
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number2128441503
The fax number associated with the location address of the provider being identified.
NPI1306868815
10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider.
Healthcare Provider Taxonomy 1363LP0200X
Provider Enumeration Date07/24/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Updated05.09.2013
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)EDUARDO SANTOS DEL ROSARIO
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 AddressPO BOX 95000-2435
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 NamePHILADELPHIA
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 NamePA
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 Code191952435
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 Number2128448932
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".
Provider Business Mailing Address Fax Number2128446962
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
Healthcare Provider Taxonomy Code #1363LP0200X
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 1Nurse Practitioner
Provider License Number 1099007864N1
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 1OR
Healthcare Provider Primary Taxonomy Switch 1N
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.
Healthcare Provider Taxonomy Code 2363LF0000X
Healthcare Provider Taxonomy 2Nurse Practitioner
Provider License Number 2336714
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 2OR
Healthcare Provider Primary Taxonomy Switch 2Y
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.
Other Provider Identifier 1290830
Other Provider Identifier #1
Other Provider Identifier Type 15
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 1OR
Other Provider Identifier State #1
Other Provider Identifier 2208VP0014X
Other Provider Identifier #2
Other Provider Identifier Type 21
  • 1 - Other
  • 5 - MEDICAID
Other Provider Identifier State 2NY
Other Provider Identifier State #2
Other Provider Identifier Issuer 2DPMPC
Other Provider Identifier Issuer #2
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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