1306936372 NPI number — DR. ELIZABETH M LACHAPELLE PHD

Table of content: DR. ELIZABETH M LACHAPELLE PHD (NPI 1306936372)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306936372 NPI number — DR. ELIZABETH M LACHAPELLE PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LACHAPELLE
Provider First Name:
ELIZABETH
Provider Middle Name:
M
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCANLON
Provider Other First Name:
ELIZABETH
Provider Other Middle Name:
MARY
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PHD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1306936372
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 42
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLYMOUTH
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03264
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-536-5223
Provider Business Mailing Address Fax Number:
603-536-5223

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLYMOUTH
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03264-1592
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-536-5223
Provider Business Practice Location Address Fax Number:
603-536-5223
Provider Enumeration Date:
10/13/2006

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: 103TC0700X , with the licence number:  891 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TC0700X , with the licence number: 4999 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1306936372 . This is a "INDIVIDUAL NPI" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 1912079443 . This is a "GROUP NPI" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 27210 . This is a "PTAN" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 30421468 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0609214YONH02 . This is a "BCBS BHN NH VT MA CT" identifier . This identifiers is of the category "OTHER".




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