1437342466 NPI number — LINDSAY E BONSANTO APN-C

Table of content: LINDSAY E BONSANTO APN-C (NPI 1437342466)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437342466 NPI number — LINDSAY E BONSANTO APN-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BONSANTO
Provider First Name:
LINDSAY
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APN-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DUNCAN
Provider Other First Name:
LINDSAY
Provider Other Middle Name:
E
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APN-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1437342466
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/15/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
605 HAMBURG TPKE
Provider Second Line Business Mailing Address:
APT 209
Provider Business Mailing Address City Name:
POMPTON LAKES
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07442-1461
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-248-6685
Provider Business Mailing Address Fax Number:
973-389-9976

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
220 HAMBURG TPKE
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
WAYNE
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07470-2110
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-389-9975
Provider Business Practice Location Address Fax Number:
973-389-9976
Provider Enumeration Date:
08/22/2007

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: 363LA2200X , with the licence number:  26NJ00146400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com