1568469427 NPI number — PROF. ARLENE J MILLAN O.T.

Table of content: PROF. ARLENE J MILLAN O.T. (NPI 1568469427)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568469427 NPI number — PROF. ARLENE J MILLAN O.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLAN
Provider First Name:
ARLENE
Provider Middle Name:
J
Provider Name Prefix Text:
PROF.
Provider Name Suffix Text:
Provider Credential Text:
O.T.
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:
1568469427
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
HC 1 BOX 8064
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN GERMAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00683-9713
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-892-4357
Provider Business Mailing Address Fax Number:
787-892-4357

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
153 CALLE LUNA
Provider Second Line Business Practice Location Address:
EDF SAN JOSE
Provider Business Practice Location Address City Name:
SAN GERMAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00683-4332
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-892-4357
Provider Business Practice Location Address Fax Number:
787-892-4357
Provider Enumeration Date:
07/06/2005

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: 225XH1200X , with the licence number:  503 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 3304132 . This is a "ACAA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 870042 . This is a "MMM" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 50044 . This is a "PREFERED MEDICARE CHOICE" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".
  • Identifier: 6830078 . This is a "HUMANA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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