1306074109 NPI number — DR. TINA CARITA LOVEN D.O.

Table of content: DR. TINA CARITA LOVEN D.O. (NPI 1306074109)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306074109 NPI number — DR. TINA CARITA LOVEN D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LOVEN
Provider First Name:
TINA
Provider Middle Name:
CARITA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
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:
1306074109
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ONE MEDICAL CENTER BLVD.
Provider Second Line Business Mailing Address:
ACP, SUITE 232
Provider Business Mailing Address City Name:
UPLAND
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19013-3902
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
844-464-6387
Provider Business Mailing Address Fax Number:
215-762-3161

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
219 N BROAD STREET
Provider Second Line Business Practice Location Address:
7TH FLOOR
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19107-1519
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
844-464-6387
Provider Business Practice Location Address Fax Number:
215-239-3037
Provider Enumeration Date:
06/30/2009

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: 207T00000X , with the licence number:  OS019878 , 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)