1265579007 NPI number — DR. RICHARD BRAZIER PINDERHUGHS PSG.D.

Table of content: DR. RICHARD BRAZIER PINDERHUGHS PSG.D. (NPI 1265579007)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265579007 NPI number — DR. RICHARD BRAZIER PINDERHUGHS PSG.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PINDERHUGHS
Provider First Name:
RICHARD
Provider Middle Name:
BRAZIER
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSG.D.
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:
1265579007
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
639 GRANITE ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRAINTREE
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02184-5366
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
781-413-6288
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
350 CAMBRIDGE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02141-1204
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
617-547-0909
Provider Business Practice Location Address Fax Number:
617-497-5952
Provider Enumeration Date:
01/31/2007

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: 103T00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com