1720077878 NPI number — IOANNA GIATIS KESSLER D.O., FACOFP

Table of content: IOANNA GIATIS KESSLER D.O., FACOFP (NPI 1720077878)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720077878 NPI number — IOANNA GIATIS KESSLER D.O., FACOFP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GIATIS KESSLER
Provider First Name:
IOANNA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O., FACOFP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GIATIS KESSLER
Provider Other First Name:
IOANNA
Provider Other Middle Name:
Z
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.O., FACOFP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1720077878
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/25/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2920 HIGHWOODS BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RALEIGH
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27604-0010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-498-4490
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
231 N JUDD PKWY NE
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
FUQUAY VARINA
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27526-2385
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-235-6410
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/20/2005

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: 207Q00000X , with the licence number:  34007705G , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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