1003144205 NPI number — JOCELYN PAIGE SAPPINGTON OTR/L

Table of content: JOCELYN PAIGE SAPPINGTON OTR/L (NPI 1003144205)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003144205 NPI number — JOCELYN PAIGE SAPPINGTON OTR/L

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAPPINGTON
Provider First Name:
JOCELYN
Provider Middle Name:
PAIGE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
OTR/L
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CONRAD
Provider Other First Name:
JOCELYN
Provider Other Middle Name:
PAIGE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
OTR/L
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1003144205
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/04/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 LOCUST ST
Provider Second Line Business Mailing Address:
SUITE 2A
Provider Business Mailing Address City Name:
CORAOPOLIS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15108-3954
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-299-0704
Provider Business Mailing Address Fax Number:
412-299-2823

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2853 OXFORD BOULEVARD
Provider Second Line Business Practice Location Address:
SUITE 103
Provider Business Practice Location Address City Name:
ALLISON PARK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15101-2443
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-299-0704
Provider Business Practice Location Address Fax Number:
412-299-2823
Provider Enumeration Date:
11/27/2009

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: 225X00000X , with the licence number:  OC012338 , 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)





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