1407801590 NPI number — NIKOL MICHELLE TEWS PT OCS

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407801590 NPI number — NIKOL MICHELLE TEWS PT OCS

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

TEWS

Provider First Name:

NIKOL

Provider Middle Name:

MICHELLE

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

PT OCS

Provider Gender Code:

F

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:

1407801590

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

07/08/2007

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

PO BOX 3340

Provider Second Line Business Mailing Address:

NEW VALLEY REHAB

Provider Business Mailing Address City Name:

EASTON

Provider Business Mailing Address State Name:

PA

Provider Business Mailing Address Postal Code:

18043-3340

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

484-851-3386

Provider Business Mailing Address Fax Number:

484-851-3469

Provider First Line Business Practice Location Address:

2006 CENTER ST

Provider Second Line Business Practice Location Address:

REHAB PARTNERS

Provider Business Practice Location Address City Name:

NORTHAMPTON

Provider Business Practice Location Address State Name:

PA

Provider Business Practice Location Address Postal Code:

18067-1321

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

610-262-0300

Provider Business Practice Location Address Fax Number:

610-262-3037

Provider Enumeration Date:

05/24/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 225100000X , with the licence number:  PT007214L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 3336072 . This is a "HMO" identifier . This identifiers is of the category "OTHER".
• Identifier: 4572840 . This is a "PPO" identifier . This identifiers is of the category "OTHER".
• Identifier: 50020667 . This is a "CAPITAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: PT007214L . This is a "US DEPT OF LABOR" identifier . This identifiers is of the category "OTHER".
• Identifier: TW768394 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
• Identifier: 01604670 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
• Identifier: 0712335000 . This is a "HMO KEYSTONE EAST" identifier . This identifiers is of the category "OTHER".
• Identifier: 20033075 . This is a "AMERIHEALTH MERCY" identifier . This identifiers is of the category "OTHER".
• Identifier: 50020667 . This is a "CAPITAL ADVANTAGE BLUE CR" identifier . This identifiers is of the category "OTHER".
• Identifier: 768394 . This is a "PPO PERSONAL CHOICE" identifier . This identifiers is of the category "OTHER".
• Identifier: 073630 . This is a "MEDICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: TW768394 . This is a "BLUE SHIELD PA HIGHMARK" identifier . This identifiers is of the category "OTHER".