1184652273 NPI number — FRANK MARRAPESE

Table of content: (NPI 1184652273)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184652273 NPI number — FRANK MARRAPESE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRANK MARRAPESE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
MOMENTUM THERAPEUTICS
Provider Other Organization Name Type Code:
3
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:
1184652273
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
41 6TH AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16125-9723
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-588-3330
Provider Business Mailing Address Fax Number:
724-588-1338

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
41 6TH AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GREENVILLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16125-9723
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-588-3330
Provider Business Practice Location Address Fax Number:
724-588-1338
Provider Enumeration Date:
06/29/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MARRAPESE
Authorized Official First Name:
FRANK
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER/DIRECTOR
Authorized Official Telephone Number:
724-588-3330

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  PT003194L , 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: 0072999730002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".