1093979494 NPI number — DR. ANDREA ROSENBAUM VOGEL PH.D., M.ED

Table of content: DR. ANDREA ROSENBAUM VOGEL PH.D., M.ED (NPI 1093979494)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093979494 NPI number — DR. ANDREA ROSENBAUM VOGEL PH.D., M.ED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROSENBAUM VOGEL
Provider First Name:
ANDREA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D., M.ED
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ROSENBAUM VOGEL
Provider Other First Name:
ANDREA
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PH.D., M.ED
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1093979494
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
429 GAMMON PLACE
Provider Second Line Business Mailing Address:
SUITE 200
Provider Business Mailing Address City Name:
MADISON
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53719
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
608-274-5181
Provider Business Mailing Address Fax Number:
608-274-2848

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
429 GAMMON PLACE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
MADISON
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53719
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
608-824-7243
Provider Business Practice Location Address Fax Number:
608-821-0938
Provider Enumeration Date:
07/15/2008

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: 101YP2500X , with the licence number:  4065-125 , registered in the state of WI ; 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