1336370071 NPI number — ALLIED THERAPY ASSOCIATES LLC

Table of content: (NPI 1336370071)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336370071 NPI number — ALLIED THERAPY ASSOCIATES LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ALLIED THERAPY ASSOCIATES LLC
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:
1336370071
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/14/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1246 W MAIN ST
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
NORRISTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19401-4365
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-681-9466
Provider Business Mailing Address Fax Number:
484-681-9467

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1246 W MAIN ST
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
NORRISTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19401-4365
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-681-9466
Provider Business Practice Location Address Fax Number:
484-681-9467
Provider Enumeration Date:
07/29/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
PETERY
Authorized Official First Name:
JAN
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
484-681-9466

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT007947L , 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)