1487634291 NPI number — RICHARD D ALLATT MD PC

Table of content: (NPI 1487634291)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487634291 NPI number — RICHARD D ALLATT MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
RICHARD D ALLATT MD PC
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:
RICHARD D. ALLATT, MD, PC.
Provider Other Organization Name Type Code:
4
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:
1487634291
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/05/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 251
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOALSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16827-0000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-359-5620
Provider Business Mailing Address Fax Number:
814-359-5629

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
HEALTHSOUTH
Provider Second Line Business Practice Location Address:
550 W COLLEGE AVE
Provider Business Practice Location Address City Name:
PLEASANT GAP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16823-0000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-359-5620
Provider Business Practice Location Address Fax Number:
814-359-5629
Provider Enumeration Date:
01/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
ALLATT
Authorized Official First Name:
RICHARD
Authorized Official Middle Name:
D
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
814-359-5620

Provider Taxonomy Codes

  • Taxonomy code: 208100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 002649 . This is a "HIGHMARK GROUP#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1007409100004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 02748200 . This is a "CAPITAL BCBS GROUP#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1015 . This is a "GEISINGER GROUP#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: CI7521 . This is a "RAILROAD MEDICARE GROUP#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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