1932447273 NPI number — MS. LORRAINE M DEEB MS ED

Table of content: MS. LORRAINE M DEEB MS ED (NPI 1932447273)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932447273 NPI number — MS. LORRAINE M DEEB MS ED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEEB
Provider First Name:
LORRAINE
Provider Middle Name:
M
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS ED
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CASTLEY
Provider Other First Name:
LORRAINE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS ED
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1932447273
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8823 COLONIAL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11209-5501
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-491-4996
Provider Business Mailing Address Fax Number:
718-491-4996

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 TYRELLAN AVE
Provider Second Line Business Practice Location Address:
SUITE 120
Provider Business Practice Location Address City Name:
STATEN ISLAND
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10309-2624
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-281-3640
Provider Business Practice Location Address Fax Number:
347-215-2088
Provider Enumeration Date:
01/22/2013

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: 225400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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