1568442515 NPI number — DR. NED PETER DEVLIN D.C.

Table of content: DR. NED PETER DEVLIN D.C. (NPI 1568442515)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568442515 NPI number — DR. NED PETER DEVLIN D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEVLIN
Provider First Name:
NED
Provider Middle Name:
PETER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
M

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:
1568442515
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/28/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
999 BERKSHIRE BLVD
Provider Second Line Business Mailing Address:
SUITE 260
Provider Business Mailing Address City Name:
WYOMISSING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19610-1260
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-236-0200
Provider Business Mailing Address Fax Number:
610-373-6166

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
999 BERKSHIRE BLVD
Provider Second Line Business Practice Location Address:
SUITE 260
Provider Business Practice Location Address City Name:
WYOMISSING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19610-1260
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-236-0200
Provider Business Practice Location Address Fax Number:
610-685-6555
Provider Enumeration Date:
01/17/2006

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: 111N00000X , with the licence number:  DC-006459-L , 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: 01566793 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1000071 . This is a "AMERICAN SPECIALTY HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3675836 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 855233 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1039987 . This is a "AETNA HMO ID#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 03086900 . This is a "CAPITAL BLUE CROSS GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1038798 . This is a "AETNA HMO GROUP #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 02160501 . This is a "CAPITAL BLUE CROSS INDIV" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 5478575 . This is a "AETNA PPO ID#" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".