1376774240 NPI number — MEREDITH A LEMBESIS PT

Table of content: MEREDITH A LEMBESIS PT (NPI 1376774240)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376774240 NPI number — MEREDITH A LEMBESIS PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LEMBESIS
Provider First Name:
MEREDITH
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT
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:
1376774240
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/29/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2021 K ST NW STE 215
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WASHINGTON
Provider Business Mailing Address State Name:
DC
Provider Business Mailing Address Postal Code:
20006-1003
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
202-466-9719
Provider Business Mailing Address Fax Number:
202-466-9465

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2021 K ST NW STE 215
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
DC
Provider Business Practice Location Address Postal Code:
20006-1003
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
202-466-9719
Provider Business Practice Location Address Fax Number:
202-466-9465
Provider Enumeration Date:
07/27/2009

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: 174400000X , with the licence number:  070-017199 , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2251X0800X , with the licence number: PT 871916 , registered in the state of DC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 070-017199 . This is a "LICENSE# 070-017199" identifier , issued by the state of ( IL ) . This identifiers is of the category "OTHER".
  • Identifier: PT871916 . This is a "GOVERNMENT OF D.C. DEPARTMENT OF HEALTH, BOARD OF PHYSICAL THERAPY" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".