1467666446 NPI number — CECILE M STARR MS, CAC, ICADC, CCBT

Table of content: CECILE M STARR MS, CAC, ICADC, CCBT (NPI 1467666446)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467666446 NPI number — CECILE M STARR MS, CAC, ICADC, CCBT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STARR
Provider First Name:
CECILE
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS, CAC, ICADC, CCBT
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:
1467666446
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
204 MAIN STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORANGEVILLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17859
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-524-9477
Provider Business Mailing Address Fax Number:
570-524-9492

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 MARKET ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LEWISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17837-1236
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-524-9477
Provider Business Practice Location Address Fax Number:
570-524-9492
Provider Enumeration Date:
05/09/2007

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: 101Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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