1386622256 NPI number — DONNA MARIE KOWARD MD

Table of content: DREW WILLIAM MALLERY (NPI 1265294524)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386622256 NPI number — DONNA MARIE KOWARD MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KOWARD
Provider First Name:
DONNA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1386622256
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/10/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
76 STIRLING RD
Provider Second Line Business Mailing Address:
STE 201
Provider Business Mailing Address City Name:
WARREN
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07059-5751
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-755-5437
Provider Business Mailing Address Fax Number:
908-755-6905

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
76 STIRLING RD
Provider Second Line Business Practice Location Address:
STE 201
Provider Business Practice Location Address City Name:
WARREN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07059-5751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-755-5437
Provider Business Practice Location Address Fax Number:
908-755-6905
Provider Enumeration Date:
01/02/2006

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: 208000000X , with the licence number:  25MA06652200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2080A0000X , with the licence number: 25MA06652200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0650522000 . This is a "AMERIHEALTH HMO PIN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: K4815 . This is a "HORIZON BCBS HMO PIN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 3211463 . This is a "AETNA HMO PIN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 38823 . This is a "UNIVERSITY HEALTH PLAN ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 4173951-008 . This is a "CIGNA PIN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1K5284 . This is a "HEALTH NET PIN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 0501095 . This is a "AETNA HMO GROUP ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 956005 . This is a "AMERIHEALTH PPO GROUP ID" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P2173649 . This is a "OXFORD PIN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com