1134153489 NPI number — MS. SANDRA MEYER LORELL RN, MSW

Table of content: MS. SANDRA MEYER LORELL RN, MSW (NPI 1134153489)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134153489 NPI number — MS. SANDRA MEYER LORELL RN, MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LORELL
Provider First Name:
SANDRA
Provider Middle Name:
MEYER
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RN, MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MEYER
Provider Other First Name:
SANDRA
Provider Other Middle Name:
LEE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1134153489
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 LADD ST
Provider Second Line Business Mailing Address:
4TH FLOOR
Provider Business Mailing Address City Name:
PORTSMOUTH
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03801-4087
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-334-3311
Provider Business Mailing Address Fax Number:
603-433-6341

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 LADD ST
Provider Second Line Business Practice Location Address:
4TH FLOOR
Provider Business Practice Location Address City Name:
PORTSMOUTH
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03801-4087
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-334-3311
Provider Business Practice Location Address Fax Number:
603-433-6341
Provider Enumeration Date:
07/11/2006

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: 104100000X , with the licence number:  203 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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