1164639860 NPI number — DAVID TRESSA COTAIL

Table of content: DR. PAUL CHO DMD, MD (NPI 1558717629)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164639860 NPI number — DAVID TRESSA COTAIL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TRESSA
Provider First Name:
DAVID
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
COTAIL
Provider Gender Code:
M

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:
1164639860
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:
151 REAR SOUTH RIVER ST
Provider Second Line Business Mailing Address:
APT A
Provider Business Mailing Address City Name:
PLAINS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18705
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-239-5274
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
149 SOUTH HUNTER HIGHWAY
Provider Second Line Business Practice Location Address:
THERAPY DEPT
Provider Business Practice Location Address City Name:
DRUMS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18222
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-788-7321
Provider Business Practice Location Address Fax Number:
570-788-7267
Provider Enumeration Date:
05/16/2007

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 , with the licence number:  OP001986L , 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)





Copyright © 2007-2025 www.npivalidator.com