1841263563 NPI number — MS. CHERYL LYNN MONTALBANO-RAHMANY MA

Table of content: MS. CHERYL LYNN MONTALBANO-RAHMANY MA (NPI 1841263563)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841263563 NPI number — MS. CHERYL LYNN MONTALBANO-RAHMANY MA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MONTALBANO-RAHMANY
Provider First Name:
CHERYL
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MA
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:
1841263563
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/19/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2158 45TH ST # 202
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HIGHLAND
Provider Business Mailing Address State Name:
IN
Provider Business Mailing Address Postal Code:
46322-3742
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
219-386-1092
Provider Business Mailing Address Fax Number:
219-476-7558

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
253 INDIANA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
VALPARAISO
Provider Business Practice Location Address State Name:
IN
Provider Business Practice Location Address Postal Code:
46383-5542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
219-386-1092
Provider Business Practice Location Address Fax Number:
219-476-7558
Provider Enumeration Date:
02/13/2006

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: 101YA0400X , with the licence number:  87000794A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: 39001744A , registered in the state of IN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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