1841235561 NPI number — JOANNE M KAIMAN P.T.

Table of content: JOANNE M KAIMAN P.T. (NPI 1841235561)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841235561 NPI number — JOANNE M KAIMAN P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAIMAN
Provider First Name:
JOANNE
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
P.T.
Provider Gender Code:
F

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:
1841235561
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/26/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9530 COSNER DR
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
FREDERICKSBURG
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22408-7760
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-361-1833
Provider Business Mailing Address Fax Number:
540-361-1829

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9530 COSNER DR
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
FREDERICKSBURG
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22408-7760
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-361-1833
Provider Business Practice Location Address Fax Number:
540-361-1829
Provider Enumeration Date:
06/17/2006

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: 225100000X , with the licence number:  PT870149 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 521453370 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 6165203 . This is a "CIGNA" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 7439123 . This is a "MAMSI LIFE & HEALTH" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 89790009 . This is a "CAREFIRST BC/BS" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: P00264274 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 521453370 . This is a "NCPPO" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".




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