1023228616 NPI number — MRS. CONSTANCE COTTER WEISENSEEL MSW

Table of content: MRS. CONSTANCE COTTER WEISENSEEL MSW (NPI 1023228616)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023228616 NPI number — MRS. CONSTANCE COTTER WEISENSEEL MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEISENSEEL
Provider First Name:
CONSTANCE
Provider Middle Name:
COTTER
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COTTER
Provider Other First Name:
CONSTANCE
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1023228616
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12 E 86TH ST
Provider Second Line Business Mailing Address:
# 1124
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10028-0506
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-396-3597
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
12 E 86TH ST
Provider Second Line Business Practice Location Address:
# 1124
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10028-0506
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-396-3597
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/23/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  027833-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 106H00000X , with the licence number: 027833-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)