Active NPI
Manuel Bulauitan
- Specialist
- Jamaica, NY
National Provider Identifier
1710915418
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- License
- 121369
- Legal business name
- MANUEL BULAUITAN
- Practice address
- 17706 Wexford Ter
Jamaica, NY 11432-2927 - Phone
- (718) 291-9384
- NPI assigned
- Jun 29, 2006
- Last updated
- Mar 10, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Manuel Bulauitan
- Title
- Sole Proprieter
- Phone
- (718) 291-9384
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 121369 | NY | Primary |
Addresses
Primary practice location
17706 Wexford Ter
Jamaica, NY 11432-2927
Mailing address
17706 Wexford Ter
Jamaica, NY 11432-2927
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00246213 | Medicaid | NY |
National Provider Directory
National Provider Directory- Tax ID family
- Manuel Bulauitan
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Specialist
- Jamaica Estates, NY
- NPI 1407010200
Locations
17706 Wexford Ter
Jamaica, NY 11432
Phone (718) 262-9456
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1151539200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1205107200000",
"number": "1710915418",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17706 WEXFORD TER",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114322927"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17706 WEXFORD TER",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114322927",
"telephone_number": "718-291-9384"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MANUEL BULAUITAN",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-29",
"last_updated": "2008-03-10",
"status": "A",
"authorized_official_last_name": "BULAUITAN",
"authorized_official_first_name": "MANUEL",
"authorized_official_title_or_position": "SOLE PROPRIETER",
"authorized_official_telephone_number": "718-291-9384"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NY",
"license": "121369",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00246213",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.