1467452052 NPI number — MS. SUZANNE M STEPANSKI M.D.

Table of content: MS. SUZANNE M STEPANSKI M.D. (NPI 1467452052)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467452052 NPI number — MS. SUZANNE M STEPANSKI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEPANSKI
Provider First Name:
SUZANNE
Provider Middle Name:
M
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1467452052
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/19/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 N ACADEMY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DANVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17822-4903
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-271-6144
Provider Business Mailing Address Fax Number:
570-271-6578

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2407 REICHART RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BLOOMSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17815-8969
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-784-8303
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/26/2005

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: 207Q00000X , with the licence number:  OS015842 , 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: 194L8ST . This is a "ATRIUM COMMERCIAL" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 2115052 . This is a "FIRST HEALTH" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 5072 . This is a "MMSI" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: P00184725 . This is a "RAILROAD-MEDICARE ELROY" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: P00051176 . This is a "RAILROAD MEDICARE - HILLS" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 194L8ST . This is a "MINNESOTA BCBS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 39092953818 . This is a "UNITY ELROY CLINIC" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 43507300 , issued by the state of ( WI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 39092953819 . This is a "UNITY - HILLSBORO CLINIC" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 4120042P01 . This is a "CIGNA" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 1042944 . This is a "PHYSICIANS PLUS" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: 13474 . This is a "DEAN HEALTH PLAN" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".
  • Identifier: HP67024 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".




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