1215911482 NPI number — MS. GLORIA CZERPAK LSW

Table of content: MS. GLORIA CZERPAK LSW (NPI 1215911482)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1215911482 NPI number — MS. GLORIA CZERPAK LSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CZERPAK
Provider First Name:
GLORIA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1215911482
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:
109 S MARKET ST
Provider Second Line Business Mailing Address:
LIGONIER VALLEY LEARNING CENTER INC
Provider Business Mailing Address City Name:
LIGONIER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15658-1214
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-238-0355
Provider Business Mailing Address Fax Number:
724-238-0352

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
117 JUNIPER LN
Provider Second Line Business Practice Location Address:
LIGONIER VALLEY LEARNING CENTER INC
Provider Business Practice Location Address City Name:
LIGONIER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15658-9727
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-238-5556
Provider Business Practice Location Address Fax Number:
724-238-9533
Provider Enumeration Date:
12/01/2005

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: 104100000X , with the licence number:  SW009555L , 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)

  • Identifier: 1001348580007 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com