1841340528 NPI number — MRS. KARLA JANE TREMBLAY M.S.P.T.

Table of content: MRS. KARLA JANE TREMBLAY M.S.P.T. (NPI 1841340528)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1841340528 NPI number — MRS. KARLA JANE TREMBLAY M.S.P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TREMBLAY
Provider First Name:
KARLA
Provider Middle Name:
JANE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S.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:
DEGRAFFT
Provider Other First Name:
KARLA
Provider Other Middle Name:
JANE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.S.P.T.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1841340528
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/28/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
435 OLD STONE WAY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YORK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17406-6099
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
443-226-3350
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2400 KINGSTON CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YORK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17402-3650
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-755-8811
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/12/2007

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

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





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