1689857088 NPI number — MRS. JAMY ADELINA BATDORFF MPH, PA-C

Table of content: MRS. JENNIFER LYNN GALLE MA, LCPC (NPI 1508195736)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689857088 NPI number — MRS. JAMY ADELINA BATDORFF MPH, PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BATDORFF
Provider First Name:
JAMY
Provider Middle Name:
ADELINA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MPH, PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
BARAHONA
Provider Other First Name:
JAMY
Provider Other Middle Name:
ADELINA
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1689857088
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/24/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11116 MEDICAL CAMPUS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAGERSTOWN
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21742-6710
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-790-8300
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11116 MEDICAL CAMPUS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAGERSTOWN
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21742-6710
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-790-8300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/10/2007

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: 363AM0700X , with the licence number:  C0003680 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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