1003241142 NPI number — ARLYN RODILLAS DELROSARIO ARLYN DEL ROSARIO

Table of content: ARLYN RODILLAS DELROSARIO ARLYN DEL ROSARIO (NPI 1003241142)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1003241142 NPI number — ARLYN RODILLAS DELROSARIO ARLYN DEL ROSARIO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DELROSARIO
Provider First Name:
ARLYN
Provider Middle Name:
RODILLAS
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARLYN DEL ROSARIO
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DEL ROSARIO
Provider Other First Name:
ARLYN
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
ARLYN DEL ROSARIO
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1003241142
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/09/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
34021 CHARLOTTE DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STERLING HEIGHTS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48312-5761
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
586-306-7408
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
34021 CHARLOTTE DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
STERLING HEIGHTS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48312-5761
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
586-306-7408
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/09/2013

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: 225100000X , with the licence number:  5501004535 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com