1194493262 NPI number — HALEY KUMAR ALLEN PT, DPT

Table of content: VIVIANE SANADA NP-C (NPI 1154981355)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194493262 NPI number — HALEY KUMAR ALLEN PT, DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALLEN
Provider First Name:
HALEY
Provider Middle Name:
KUMAR
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
KUMAR
Provider Other First Name:
HALEY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PT, DPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1194493262
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 412307
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BOSTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02241-2307
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-294-4050
Provider Business Mailing Address Fax Number:
316-760-8306

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16260 BENNETT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CULPEPER
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22701-4630
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-727-0737
Provider Business Practice Location Address Fax Number:
540-727-0738
Provider Enumeration Date:
09/02/2021

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:  TPPT395 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: CP029997T , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: CP029996T , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 2305213634 , 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)