1407854490 NPI number — DR. RAMSAY S KURBAN MD

Table of content: DR. RAMSAY S KURBAN MD (NPI 1407854490)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407854490 NPI number — DR. RAMSAY S KURBAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KURBAN
Provider First Name:
RAMSAY
Provider Middle Name:
S
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1407854490
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/10/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
845 NORMAN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEBANON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17042-7445
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-273-8091
Provider Business Mailing Address Fax Number:
717-273-9081

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
845 NORMAN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEBANON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17042-7445
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-273-8091
Provider Business Practice Location Address Fax Number:
717-273-9081
Provider Enumeration Date:
07/13/2005

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: 174400000X , with the licence number:  MD043706L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207ZD0900X , with the licence number: MD043706L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207NS0135X , with the licence number: MD043706L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1520324 . This is a "GATEWAY INS PROVIDER #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 671850HE5 . This is a "MCB/P-TAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 02024202 . This is a "CAP BC IND PROVIDER #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0012800250001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 671850 . This is a "BS IND PROVIDER #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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