1265500680 NPI number — JOAN MCCARTHY WEGLEIN WHNP-BC

Table of content: JOAN MCCARTHY WEGLEIN WHNP-BC (NPI 1265500680)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265500680 NPI number — JOAN MCCARTHY WEGLEIN WHNP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEGLEIN
Provider First Name:
JOAN
Provider Middle Name:
MCCARTHY
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
WHNP-BC
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:
1265500680
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/12/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 813
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TREXLERTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18087-0813
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-481-0481
Provider Business Mailing Address Fax Number:
610-481-0486

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
28 N 7TH ST
Provider Second Line Business Practice Location Address:
PLANNED PARENTHOOD KEYSTONE
Provider Business Practice Location Address City Name:
STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18360-2110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-424-8306
Provider Business Practice Location Address Fax Number:
570-476-2698
Provider Enumeration Date:
12/01/2006

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: 363LW0102X , with the licence number:  26NJ00121800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0131776 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".




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