1174735401 NPI number — Commonwealth Center for Children and Adolescents POOJA SABHARWAL MD

Table of content: POOJA SABHARWAL MD (NPI 1174735401)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174735401 NPI number — Commonwealth Center for Children and Adolescents POOJA SABHARWAL MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Commonwealth Center for Children and Adolescents
Provider Last Name:
SABHARWAL
Provider First Name:
POOJA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1174735401
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:
PO BOX 400
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CHARLOTTESVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22945
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
434-987-3180
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
P.O. Box 4000
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
Staunton
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
24402-4000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-332-2100
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/07/2007

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: 390200000X , with the licence number:  0101261579 , registered in the state of VA ; 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