1699071902 NPI number — GLORIA HOSTETLER BURKEY B.S., M.A., L.P.C.

Table of content: GLORIA HOSTETLER BURKEY B.S., M.A., L.P.C. (NPI 1699071902)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699071902 NPI number — GLORIA HOSTETLER BURKEY B.S., M.A., L.P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BURKEY
Provider First Name:
GLORIA
Provider Middle Name:
HOSTETLER
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
B.S., M.A., L.P.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COTCKEN
Provider Other First Name:
GLORIA
Provider Other Middle Name:
DAWNE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
B.S., M.A.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1699071902
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/03/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8320 PENNSYLVANIA AVE.
Provider Second Line Business Mailing Address:
GRACE WELLNESS CENTER
Provider Business Mailing Address City Name:
NORTH HUNTINGDON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15642
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-863-7223
Provider Business Mailing Address Fax Number:
724-863-8320

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8320 PENNSYLVANIA AVE.
Provider Second Line Business Practice Location Address:
GRACE WELLNESS CENTER
Provider Business Practice Location Address City Name:
NORTH HUNTINGDON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15642
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-863-7223
Provider Business Practice Location Address Fax Number:
724-863-8320
Provider Enumeration Date:
02/03/2011

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: 101YP2500X , with the licence number:  PC003039 , 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)





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