1477626372 NPI number — JULI WEITZEN DPM

Table of content: (NPI 1477626372)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477626372 NPI number — JULI WEITZEN DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JULI WEITZEN DPM
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:
1477626372
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/19/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
828 N HANOVER STREET
Provider Second Line Business Mailing Address:
LOWER LEVEL
Provider Business Mailing Address City Name:
POTTSTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19464
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-327-8554
Provider Business Mailing Address Fax Number:
610-323-1406

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
828 N HANOVER STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POTTSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19464
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-327-8554
Provider Business Practice Location Address Fax Number:
484-449-9684
Provider Enumeration Date:
11/16/2006

Additional Information

Authorized Official

Authorized Official Last Name:
WEITZEN
Authorized Official First Name:
JULI
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
610-327-8554

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  SC-003193L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213E00000X , with the licence number: SC0031963L , 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: 0083575000 . This is a "PERSONAL CHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 27-01105 . This is a "EVERCARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: A43405 . This is a "INTERCOUNTY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000143405 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1112351 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 50001567 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: T29547 . This is a "UPIN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com