1437309473 NPI number — DR. PAULA HOWLAND BROSCH PH.D.

Table of content: DR. PAULA HOWLAND BROSCH PH.D. (NPI 1437309473)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437309473 NPI number — DR. PAULA HOWLAND BROSCH PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BROSCH
Provider First Name:
PAULA
Provider Middle Name:
HOWLAND
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
HOWLAND
Provider Other First Name:
PAULA
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
PH.D.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1437309473
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/26/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4802 SPERRYVILLE PIKE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOODVILLE
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22749-1704
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
540-987-3174
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
257 GAY STREET
Provider Second Line Business Practice Location Address:
ROOM D
Provider Business Practice Location Address City Name:
WASHINGTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22747
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
540-675-1222
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/26/2008

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: 103TC0700X , with the licence number:  0810003913 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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