1346263928 NPI number — JAIME L KRINER PA

Table of content: JAIME L KRINER PA (NPI 1346263928)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346263928 NPI number — JAIME L KRINER PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KRINER
Provider First Name:
JAIME
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA
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:
1346263928
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/21/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5115 CENTRE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15232-1301
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-235-1020
Provider Business Mailing Address Fax Number:
412-235-1030

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5115 CENTRE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15232-1301
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-235-1020
Provider Business Practice Location Address Fax Number:
412-235-1030
Provider Enumeration Date:
07/25/2006

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: 363A00000X , with the licence number:  001382 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363A00000X , with the licence number: MA055490 , 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: 1255448155 . This is a "GHMC GROUP NPI PROVIDER I" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 290001382CT01 . This is a "BCBS & BCFP PROVIDER ID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 2V6303 . This is a "HEALTH NET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 013820 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: C01373 . This is a "GHMC MEDICARE GROUP ID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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