1689846891 NPI number — MRS. EMILY BINGHAM FORRO MED

Table of content: MRS. EMILY BINGHAM FORRO MED (NPI 1689846891)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689846891 NPI number — MRS. EMILY BINGHAM FORRO MED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FORRO
Provider First Name:
EMILY
Provider Middle Name:
BINGHAM
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MED
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BINGHAM
Provider Other First Name:
EMILY
Provider Other Middle Name:
ANNE
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1689846891
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2500 EDUCATIONAL DRIVE
Provider Second Line Business Mailing Address:
TRENT PARK ELEMENTARY SCHOOL
Provider Business Mailing Address City Name:
NEW BERN
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
28562-4400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
252-514-6481
Provider Business Mailing Address Fax Number:
252-514-6485

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2500 EDUCATIONAL DRIVE
Provider Second Line Business Practice Location Address:
TRENT PARK ELEMENTARY SCHOOL
Provider Business Practice Location Address City Name:
NEW BERN
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
28562-4400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
252-514-6481
Provider Business Practice Location Address Fax Number:
252-514-6485
Provider Enumeration Date:
03/27/2008

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: 101YM0800X , with the licence number:  4907 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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