1528172707 NPI number — MILDIN, INC

Table of content: (NPI 1528172707)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528172707 NPI number — MILDIN, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MILDIN, INC
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:
CARDIN & MILLER PHYSICAL THERAPY
Provider Other Organization Name Type Code:
5
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:
1528172707
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
290 E POMFRET ST
Provider Second Line Business Mailing Address:
SUITE 1
Provider Business Mailing Address City Name:
CARLISLE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17013-2579
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-245-0400
Provider Business Mailing Address Fax Number:
717-243-5688

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
290 E POMFRET ST
Provider Second Line Business Practice Location Address:
SUITE 1
Provider Business Practice Location Address City Name:
CARLISLE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17013-2579
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-245-0400
Provider Business Practice Location Address Fax Number:
717-243-5688
Provider Enumeration Date:
08/18/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CARDIN
Authorized Official First Name:
BRIAN
Authorized Official Middle Name:
DONALD
Authorized Official Title or Position:
PHYSICAL THERAPIST, PRESIDENT
Authorized Official Telephone Number:
717-245-0400

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  PT013395L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 335E00000X , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: DF0847 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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