1497797070 NPI number — ASSOCIATES IN NEUROPSYCHOLOGY & COLLABORATIVE HEALTHCARE, PC

Table of content: (NPI 1497797070)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497797070 NPI number — ASSOCIATES IN NEUROPSYCHOLOGY & COLLABORATIVE HEALTHCARE, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSOCIATES IN NEUROPSYCHOLOGY & COLLABORATIVE HEALTHCARE, PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1497797070
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1521 WASHINGTON BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLIAMSPORT
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17701-5426
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-322-6484
Provider Business Mailing Address Fax Number:
570-322-6788

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1521 WASHINGTON BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLIAMSPORT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17701-5426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-322-6484
Provider Business Practice Location Address Fax Number:
570-322-6788
Provider Enumeration Date:
06/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SEILER
Authorized Official First Name:
CHRISTIE
Authorized Official Middle Name:
B
Authorized Official Title or Position:
CLINICAL DIRECTOR
Authorized Official Telephone Number:
570-322-6484

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103G00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 1800748 . This is a "HIGHMARK BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: DF1578 . This is a "RAILROAD MEDICARE/PALMETTO GBA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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