1487824298 NPI number — MISS ALAINA MARIE DIUMBERTO PTA

Table of content: MISS ALAINA MARIE DIUMBERTO PTA (NPI 1487824298)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487824298 NPI number — MISS ALAINA MARIE DIUMBERTO PTA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DIUMBERTO
Provider First Name:
ALAINA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
PTA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DIUMBERTO
Provider Other First Name:
ALAINA
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
PTA
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1487824298
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/10/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9 MAPLE TREE CT
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
GREENVILLE
Provider Business Mailing Address State Name:
SC
Provider Business Mailing Address Postal Code:
29615-4070
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
864-286-8288
Provider Business Mailing Address Fax Number:
864-286-8289

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9 MAPLE TREE CT
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
GREENVILLE
Provider Business Practice Location Address State Name:
SC
Provider Business Practice Location Address Postal Code:
29615-4070
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
864-286-8288
Provider Business Practice Location Address Fax Number:
864-286-8289
Provider Enumeration Date:
03/07/2008

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: 225200000X , with the licence number:  2202 , registered in the state of SC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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