1043265861 NPI number — MRS. RAMONA GERLINDE PEDEMONTE P.T.

Table of content: MRS. RAMONA GERLINDE PEDEMONTE P.T. (NPI 1043265861)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043265861 NPI number — MRS. RAMONA GERLINDE PEDEMONTE P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PEDEMONTE
Provider First Name:
RAMONA
Provider Middle Name:
GERLINDE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KIRBS
Provider Other First Name:
RAMONA
Provider Other Middle Name:
GERLINDE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
P.T.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1043265861
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:
PO BOX 812
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
INDIAN TRAIL
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28079-0812
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
704-821-3222
Provider Business Mailing Address Fax Number:
704-821-3290

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 PARK RD E
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
INDIAN TRAIL
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28079-7622
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
704-821-3222
Provider Business Practice Location Address Fax Number:
704-821-3290
Provider Enumeration Date:
05/23/2006

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: 225100000X , with the licence number:  9594 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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