1063907848 NPI number — MS. ASHLEY ELIZABETH TOOHILL PA-C

Table of content: MS. ASHLEY ELIZABETH TOOHILL PA-C (NPI 1063907848)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063907848 NPI number — MS. ASHLEY ELIZABETH TOOHILL PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TOOHILL
Provider First Name:
ASHLEY
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

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:
1063907848
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/01/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
345 ST. PAUL PLACE
Provider Second Line Business Mailing Address:
DEPT OF MEDICINE
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21202
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-332-9694
Provider Business Mailing Address Fax Number:
410-787-4846

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
345 ST. PAUL PLACE
Provider Second Line Business Practice Location Address:
DEPT OF MEDICINE
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-332-9694
Provider Business Practice Location Address Fax Number:
410-787-4846
Provider Enumeration Date:
06/25/2018

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: 363A00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: C0008932 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 05361775 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com