1982714275 NPI number — MRS. ROSANNA A CARPITA-ELMER MD

Table of content: MRS. ROSANNA A CARPITA-ELMER MD (NPI 1982714275)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982714275 NPI number — MRS. ROSANNA A CARPITA-ELMER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CARPITA-ELMER
Provider First Name:
ROSANNA
Provider Middle Name:
A
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CARPITA
Provider Other First Name:
ROSANNA
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1982714275
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/17/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8532 W CAPITOL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MILWAUKEE
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53222-1848
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
414-463-2607
Provider Business Mailing Address Fax Number:
414-463-6743

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10500 W LOOMIS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FRANKLIN
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53132-8030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-529-9261
Provider Business Practice Location Address Fax Number:
414-529-9278
Provider Enumeration Date:
08/30/2006

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: 208000000X , with the licence number:  44610 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 44610 . This is a "MD LICENSE" identifier , issued by the state of ( WI ) . This identifiers is of the category "OTHER".




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