1043709835 NPI number — DEBORAH J CAMPOS-BARD, LMT LMT

Table of content: DEBORAH J CAMPOS-BARD, LMT LMT (NPI 1043709835)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043709835 NPI number — DEBORAH J CAMPOS-BARD, LMT LMT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAMPOS-BARD, LMT
Provider First Name:
DEBORAH
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LMT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CAMPOS-BARD
Provider Other First Name:
DEBORAH
Provider Other Middle Name:
J
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LMT
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1043709835
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/30/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1925 OREGON PIKE APT L5
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LANCASTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17601-6455
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
607-379-2722
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
439 N. DUKE ST. 2ND FL.
Provider Second Line Business Practice Location Address:
2
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17602
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-669-1030
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/07/2018

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: 225700000X , with the licence number:  MSG011684 , 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)





Copyright © 2007-2024 www.npivalidator.com