1497914469 NPI number — DR. PEGGY V STEINBRUNNER PSYD

Table of content: DR. PEGGY V STEINBRUNNER PSYD (NPI 1497914469)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497914469 NPI number — DR. PEGGY V STEINBRUNNER PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STEINBRUNNER
Provider First Name:
PEGGY
Provider Middle Name:
V
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NAVE
Provider Other First Name:
PEGGY
Provider Other Middle Name:
V
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PSYD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1497914469
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/30/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5045 RIVERVIEW RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EVERETT
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15537
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-285-1018
Provider Business Mailing Address Fax Number:
814-254-4170

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16 WATER STREET
Provider Second Line Business Practice Location Address:
STE 101
Provider Business Practice Location Address City Name:
EVERETT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-283-5535
Provider Business Practice Location Address Fax Number:
814-254-4170
Provider Enumeration Date:
06/05/2008

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: 103TC0700X , with the licence number:  PS017564 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X , with the licence number: 0547 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X , with the licence number: PY9601 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103T00000X , with the licence number: PS017564 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 103289532-0001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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