1538122056 NPI number — CORRINE GEIGER PH.D.

Table of content: CORRINE GEIGER PH.D. (NPI 1538122056)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538122056 NPI number — CORRINE GEIGER PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GEIGER
Provider First Name:
CORRINE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
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:
1538122056
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
241 CLEVELAND AVE S
Provider Second Line Business Mailing Address:
SUITE P
Provider Business Mailing Address City Name:
SAINT PAUL
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55105-1208
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
651-690-1810
Provider Business Mailing Address Fax Number:
651-699-9616

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
241 CLEVELAND AVE S
Provider Second Line Business Practice Location Address:
SUITE P
Provider Business Practice Location Address City Name:
SAINT PAUL
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55105-1208
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
651-690-1810
Provider Business Practice Location Address Fax Number:
651-699-9616
Provider Enumeration Date:
04/07/2006

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: 103T00000X , with the licence number:  LP0930 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 26423 . This is a "HEALTH PARTNERS" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 1009920 . This is a "PREFERRED ONE" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 025547500 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5771611 . This is a "AETNA" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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