1104100585 NPI number — DELAILA NAADEDEI ARYEE DPT

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 1104100585 NPI number — DELAILA NAADEDEI ARYEE DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ARYEE
Provider First Name:
DELAILA
Provider Middle Name:
NAADEDEI
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DPT
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:
1104100585
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/24/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5008 BALTIMORE AVE
Provider Second Line Business Mailing Address:
2ND FLOOR, SUITE D
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19143-4271
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-747-7383
Provider Business Mailing Address Fax Number:
217-747-1080

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5008 BALTIMORE AVE
Provider Second Line Business Practice Location Address:
2ND FLOOR, SUITE D
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19143-4271
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-650-7383
Provider Business Practice Location Address Fax Number:
215-747-1080
Provider Enumeration Date:
10/04/2011

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: 225100000X , with the licence number:  PT021445 , 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)

  • Identifier: 47-4506800 . This is a "TAX ID - VITAL STEP PHYSICAL THERAPY & FITNESS, P.C." identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1528438793 . This is a "NPI - VITAL STEP PHYSICAL THERAPY & FITNESS, P.C." identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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