1265517346 NPI number — DR. GLENN S. KAPLAN MD

Table of content: DR. GLENN S. KAPLAN MD (NPI 1265517346)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265517346 NPI number — DR. GLENN S. KAPLAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAPLAN
Provider First Name:
GLENN
Provider Middle Name:
S.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1265517346
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/03/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 PENN SQUARE EAST 9TH FL
Provider Second Line Business Mailing Address:
CHILDREN'S HEALTH CARE ASSOCIATES
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19107-3323
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
267-425-9408
Provider Business Mailing Address Fax Number:
267-425-9299

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1201 LANGHORNE NEWTOWN RD
Provider Second Line Business Practice Location Address:
ST. MARY'S MEDICAL CENTER
Provider Business Practice Location Address City Name:
LANGHORNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19047-1201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-710-2000
Provider Business Practice Location Address Fax Number:
215-710-5801
Provider Enumeration Date:
10/26/2006

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: 2080N0001X , with the licence number:  MD023206E , 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: 8013012 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5307406 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 953934 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".