1982846903 NPI number — FRANCIS J. COLLINI, MD, FACS, P.C.

Table of content: (NPI 1982846903)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982846903 NPI number — FRANCIS J. COLLINI, MD, FACS, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRANCIS J. COLLINI, MD, FACS, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1982846903
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/09/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1845 MEMORIAL HWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHAVERTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18708-1482
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-674-6525
Provider Business Mailing Address Fax Number:
570-674-6520

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1845 MEMORIAL HWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHAVERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18708-1482
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-674-6525
Provider Business Practice Location Address Fax Number:
570-674-6520
Provider Enumeration Date:
04/06/2009

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
COLLINI
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
J.
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
570-674-6525

Provider Taxonomy Codes

  • Taxonomy code: 208200000X , with the licence number:  044972E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 240003566 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 073412 . This is a "FIRST PRIORITY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 001458571 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 580391 . This is a "BC/BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".