1063766467 NPI number — ROMMYS ALEMANIA BELTRAN PHD CHT

Table of content: ROMMYS ALEMANIA BELTRAN PHD CHT (NPI 1063766467)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063766467 NPI number — ROMMYS ALEMANIA BELTRAN PHD CHT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BELTRAN
Provider First Name:
ROMMYS
Provider Middle Name:
ALEMANIA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHD CHT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHAD
Provider Other First Name:
ROMMYS
Provider Other Middle Name:
ALEMANIA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHD CHT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1063766467
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/07/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2662 HOLCOMB BRIDGE RD
Provider Second Line Business Mailing Address:
SUITE 340
Provider Business Mailing Address City Name:
ALPHARETTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30022-6819
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
770-650-0000
Provider Business Mailing Address Fax Number:
770-650-0002

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2662 HOLCOMB BRIDGE RD
Provider Second Line Business Practice Location Address:
SUITE 340
Provider Business Practice Location Address City Name:
ALPHARETTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30022-6819
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
770-650-0000
Provider Business Practice Location Address Fax Number:
770-650-0002
Provider Enumeration Date:
11/07/2012

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: 103TF0200X ; 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