1407693971 NPI number — AMANDA MAREK-MISKOLCZI LADC-II

Table of content: AMANDA MAREK-MISKOLCZI LADC-II (NPI 1407693971)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407693971 NPI number — AMANDA MAREK-MISKOLCZI LADC-II

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAREK-MISKOLCZI
Provider First Name:
AMANDA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LADC-II
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:
1407693971
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/11/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 43
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAKE PLEASANT
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01347-0043
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-588-6113
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
51 LOCUST ST STE 1
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORTHAMPTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01060-2060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-584-7425
Provider Business Practice Location Address Fax Number:
413-584-7440
Provider Enumeration Date:
07/11/2024

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: 101YA0400X , with the licence number:  23650 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com