1598393431 NPI number — JANICE GALE MOLESKY INDEPENDENT PROVIDER

Table of content: JANICE GALE MOLESKY INDEPENDENT PROVIDER (NPI 1598393431)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598393431 NPI number — JANICE GALE MOLESKY INDEPENDENT PROVIDER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MOLESKY
Provider First Name:
JANICE
Provider Middle Name:
GALE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
INDEPENDENT PROVIDER
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MOLESKY
Provider Other First Name:
JANICE
Provider Other Middle Name:
GALE
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
JANICE GALE FINLEY
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1598393431
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6253 ZILPHA CT
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FAIRFIELD TOWNSHIP
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45011-7839
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
513-465-8535
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6253 ZILPHA CT
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRFIELD TOWNSHIP
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45011-7839
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
513-465-8535
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/27/2020

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: 385H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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