1578796181 NPI number — GANRORMIC

Table of content: (NPI 1578796181)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578796181 NPI number — GANRORMIC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
GANRORMIC
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:
WEE CAN PRESCHOOL
Provider Other Organization Name Type Code:
3
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:
1578796181
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/29/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26 PAWTUCKET ROW
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORCHARD PARK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14127-3920
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-662-7456
Provider Business Mailing Address Fax Number:
716-667-2272

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 CENTRE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORCHARD PARK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14127-4100
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-667-2294
Provider Business Practice Location Address Fax Number:
716-667-2272
Provider Enumeration Date:
08/29/2009

Additional Information

Authorized Official

Authorized Official Last Name:
WETTLAUFER
Authorized Official First Name:
JULIE
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
716-667-2294

Provider Taxonomy Codes

  • Taxonomy code: 163WS0200X , with the licence number:  353200 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 21122 . This is a "NYS DEPARTMENT OF HEALTH" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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