1366406936 NPI number — ELECTROPHYSIOLOGY ASSOCIATES, P.C.

Table of content: JOHN PATRICK LEVINS M.D. (NPI 1881665974)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1366406936 NPI number — ELECTROPHYSIOLOGY ASSOCIATES, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ELECTROPHYSIOLOGY ASSOCIATES, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1366406936
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/29/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
215 PARKSIDE DR
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
COLORADO SPRINGS
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80910-3131
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
719-471-9942
Provider Business Mailing Address Fax Number:
719-471-3051

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
215 PARKSIDE DR
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
COLORADO SPRINGS
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80910-3131
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
719-471-9942
Provider Business Practice Location Address Fax Number:
719-471-3051
Provider Enumeration Date:
04/12/2006

Additional Information

Authorized Official

Authorized Official Last Name:
FORCINITO
Authorized Official First Name:
MARY
Authorized Official Middle Name:
ALLISON
Authorized Official Title or Position:
ASSISTANT OFFICE MANAGER
Authorized Official Telephone Number:
719-471-9942

Provider Taxonomy Codes

  • Taxonomy code: 207RC0001X , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 04010930 , issued by the state of ( CO ) . This identifiers is of the category "MEDICAID".




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