1255541868 NPI number — ALLAN H PURITZ

Table of content: (NPI 1255541868)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255541868 NPI number — ALLAN H PURITZ

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLAN H PURITZ
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1255541868
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/29/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
208 WASHINGTON HEIGHTS MED CTR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTMINSTER
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21157-5633
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-848-8022
Provider Business Mailing Address Fax Number:
410-848-8499

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
208 WASHINGTON HEIGHTS MED CTR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WESTMINSTER
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21157-5633
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-848-8022
Provider Business Practice Location Address Fax Number:
410-848-8499
Provider Enumeration Date:
05/23/2007

Additional Information

Authorized Official

Authorized Official Last Name:
PURITZ
Authorized Official First Name:
ALLAN
Authorized Official Middle Name:
H
Authorized Official Title or Position:
CHIROPRACTOR
Authorized Official Telephone Number:
410-848-8022

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  S01668 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: E1660001 . This is a "BLUE SHIELD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: M458 . This is a "BLUE CROSS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 1002302 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 265280 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 53322802 . This is a "BLUE CROSS" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com