1093354755 NPI number — JULIE CRANNEY

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093354755 NPI number — JULIE CRANNEY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CRANNEY
Provider First Name:
JULIE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1093354755
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/30/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7 CARNEGIE PLZ
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHERRY HILL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08003-1000
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
877-407-3422
Provider Business Mailing Address Fax Number:
877-407-4329

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10475 PERRY HWY STE 106G
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEXFORD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15090-9213
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
877-407-3422
Provider Business Practice Location Address Fax Number:
877-407-4329
Provider Enumeration Date:
12/30/2019

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 ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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