1780617209 NPI number — NOVACURE CONSULTANTS, PC

Table of content: (NPI 1780617209)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780617209 NPI number — NOVACURE CONSULTANTS, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NOVACURE CONSULTANTS, PC
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:
DIVYANG TRIVEDI MD PC
Provider Other Organization Name Type Code:
4
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:
1780617209
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/21/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 16208
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALEXANDRIA
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22302-8208
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-780-2216
Provider Business Mailing Address Fax Number:
703-780-9487

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8101 HINSON FARM RD
Provider Second Line Business Practice Location Address:
SUITE 211
Provider Business Practice Location Address City Name:
ALEXANDRIA
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22306-3403
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-780-2216
Provider Business Practice Location Address Fax Number:
703-780-9487
Provider Enumeration Date:
07/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CAFFEY
Authorized Official First Name:
SOREN
Authorized Official Middle Name:
Authorized Official Title or Position:
PHYSICIAN/OWNER
Authorized Official Telephone Number:
703-780-2216

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0640 . This is a "CAREFIRST BC BS" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".




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