1649207325 NPI number — HAROLD MILLMAN PT

Table of content: (NPI 1649207325)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649207325 NPI number — HAROLD MILLMAN PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HAROLD MILLMAN PT
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:
BETHLEHEM REHABILITATION SPECIALISTS
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:
1649207325
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
41 EAST ELIZABETH AVENUE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BETHLEHEM
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18018-6504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-868-2211
Provider Business Mailing Address Fax Number:
610-868-8871

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
41 EAST ELIZABETH AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18018-6504
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-868-2211
Provider Business Practice Location Address Fax Number:
610-868-8871
Provider Enumeration Date:
06/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MILLMAN
Authorized Official First Name:
HAROLD
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER DIRECTOR PHYSICAL THERAPIST
Authorized Official Telephone Number:
610-868-2211

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: HA906582 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0053732 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02522300 . This is a "CAPITAL BLUE CROSS" identifier . This identifiers is of the category "OTHER".




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