1487715868 NPI number — DR. ELINOR ATKINS SMITH PH.D.

Table of content: DR. ELINOR ATKINS SMITH PH.D. (NPI 1487715868)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487715868 NPI number — DR. ELINOR ATKINS SMITH PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SMITH
Provider First Name:
ELINOR
Provider Middle Name:
ATKINS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ATKINS
Provider Other First Name:
ELINOR
Provider Other Middle Name:
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
LCSW; SCH. PSYCH.
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1487715868
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 112
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SICKLERVILLE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08081-0112
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-728-4464
Provider Business Mailing Address Fax Number:
856-629-7468

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
504 SICKLERVILLE RD
Provider Second Line Business Practice Location Address:
2ND. FLOOR
Provider Business Practice Location Address City Name:
SICKLERVILLE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08081-2626
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-728-4464
Provider Business Practice Location Address Fax Number:
856-629-7468
Provider Enumeration Date:
12/12/2006

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 , with the licence number:  44SC01029500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YA0400X , with the licence number: 44SC01029500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 44SC01029500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YP2500X , with the licence number: 44SC01029500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YS0200X , with the licence number: 44SC01029500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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