1508083700 NPI number — MRS. ESTHER COMFORT KARGBO CNA

Table of content: MRS. ESTHER COMFORT KARGBO CNA (NPI 1508083700)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1508083700 NPI number — MRS. ESTHER COMFORT KARGBO CNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KARGBO
Provider First Name:
ESTHER
Provider Middle Name:
COMFORT
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NONE
Provider Other First Name:
NONE
Provider Other Middle Name:
NONE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
NONE
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1508083700
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:
123 KINGSWOOD RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19713-3054
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-456-1056
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2250 HICKORY RD STE 240
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLYMOUTH MEETING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19462-2225
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-834-1122
Provider Business Practice Location Address Fax Number:
610-834-7525
Provider Enumeration Date:
04/19/2007

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: 376K00000X , with the licence number:  NA000000702171 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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