1144476748 NPI number — MS. JUDITH ANN DANIELS

Table of content: MS. JUDITH ANN DANIELS (NPI 1144476748)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144476748 NPI number — MS. JUDITH ANN DANIELS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DANIELS
Provider First Name:
JUDITH
Provider Middle Name:
ANN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DANIELS
Provider Other First Name:
JUDITH
Provider Other Middle Name:
A.
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
P.A.-C
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1144476748
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1601 PENN AVE
Provider Second Line Business Mailing Address:
APT. 209E
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15221-5003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-243-4982
Provider Business Mailing Address Fax Number:
412-243-4982

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
VA PITTSBURGH HEALTHCARE SYSTEM
Provider Second Line Business Practice Location Address:
7180 HIGHLAND DRIVE
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15206-1297
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-365-4929
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/14/2008

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: 363AM0700X , with the licence number:  MA001063L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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