1659366847 NPI number — DANIEL CARMINE DE FALCIS MD

Table of content: DANIEL CARMINE DE FALCIS MD (NPI 1659366847)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659366847 NPI number — DANIEL CARMINE DE FALCIS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DE FALCIS
Provider First Name:
DANIEL
Provider Middle Name:
CARMINE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1659366847
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/10/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4811 JONESTOWN RD
Provider Second Line Business Mailing Address:
SUITE 123
Provider Business Mailing Address City Name:
HARRISBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17109-1745
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-651-5800
Provider Business Mailing Address Fax Number:
717-651-5808

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4811 JONESTOWN RD
Provider Second Line Business Practice Location Address:
SUITE 123
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17109-1745
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-651-5800
Provider Business Practice Location Address Fax Number:
717-651-5808
Provider Enumeration Date:
09/14/2005

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: 208100000X , with the licence number:  MD065894L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 400034000 . This is a "MARYLAND MEDICAID" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0016928000006 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01020802 . This is a "CAPITAL BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: CE1386745 . This is a "BLUE SHIELD ASSGN ACCT" identifier . This identifiers is of the category "OTHER".
  • Identifier: G37593 . This is a "SOUTH CENTRAL PREFERRED" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1699280 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2697173 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 130772 . This is a "MEDPLUS 3 RIVERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2103000 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2103000 . This is a "ALLIANCE PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 974483 . This is a "BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00431001 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1527661 . This is a "GATEWAY" identifier . This identifiers is of the category "OTHER".
  • Identifier: G37593 . This is a "HEALTHASSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: G37593 . This is a "HEALTHAMERICA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0016992800003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 41790 . This is a "GEISINGER HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: N86745 . This is a "AMERIHEALTH ADMINISTRATOR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 20019902 . This is a "AMERIHEALTH MERCY NON PAR" identifier . This identifiers is of the category "OTHER".




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