1245489053 NPI number — NU HOUSE CALLS PC

Table of content: (NPI 1245489053)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1245489053 NPI number — NU HOUSE CALLS PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NU HOUSE CALLS PC
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:
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:
1245489053
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
629 W STATE ST
Provider Second Line Business Mailing Address:
PO BOX 490
Provider Business Mailing Address City Name:
COOPERSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18036-1941
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-393-3966
Provider Business Mailing Address Fax Number:
484-863-4166

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1901 W HAMILTON ST
Provider Second Line Business Practice Location Address:
SUITE 100B
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-6459
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-973-1410
Provider Business Practice Location Address Fax Number:
610-973-1449
Provider Enumeration Date:
09/17/2008

Additional Information

Authorized Official

Authorized Official Last Name:
URANKAR
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
A
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
610-393-3966

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  MD022745E , 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: 2071073 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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