Basic Information
| Provider Information | |||||||||
| NPI: | 1669764759 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | A.E.C.A. MEDICAL PLLC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | LIVIU B. SAIMOVICI, MD | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 380 ROUTE 202 | ||||||||
| Address2: | |||||||||
| City: | SOMERS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105893222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 0142775550 | ||||||||
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| Practice Location | |||||||||
| Address1: | 380 ROUTE 202 | ||||||||
| Address2: | |||||||||
| City: | SOMERS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105893222 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9142775550 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/06/2011 | ||||||||
| LastUpdateDate: | 07/22/2011 | ||||||||
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| ProviderGenderCode: | |||||||||
| AuthorizedOfficialLastName: | SAIMOVICI | ||||||||
| AuthorizedOfficialFirstName: | LIVIU | ||||||||
| AuthorizedOfficialMiddleName: | B | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 9142775550 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
| ParentOrganizationLBN: | |||||||||
| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | M.D. | ||||||||
| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207W00000X | 154827 | NY | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 00809247 | 05 | NY | MEDICAID |