1477097913 NPI number — GLORIA CUDICIO-HAYDEN MS, NCC

Table of content: GLORIA CUDICIO-HAYDEN MS, NCC (NPI 1477097913)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477097913 NPI number — GLORIA CUDICIO-HAYDEN MS, NCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CUDICIO-HAYDEN
Provider First Name:
GLORIA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, NCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GLORIA
Provider Other First Name:
FITCH
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1477097913
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/16/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
225 S ARLINGTON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARRISBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17109-2610
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-899-1816
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
960 CENTURY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MECHANICSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17055-4530
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-795-0330
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/16/2016

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: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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