Organization Active NPI

Manuel Bulauitan

  • Specialist
  • Jamaica, NY
National Provider Identifier
1710915418
Registry record updated Mar 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
121369 Issued in NY
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, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2008

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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
00246213MedicaidNY

National Provider Directory

National Provider Directory
Tax ID family
Manuel Bulauitan2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

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.

Verify at the official NPI Registry.