1699841783 NPI number — KRISTA MARIE MCLAUGHLIN PA-C

Table of content: KRISTA MARIE MCLAUGHLIN PA-C (NPI 1699841783)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699841783 NPI number — KRISTA MARIE MCLAUGHLIN PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MCLAUGHLIN
Provider First Name:
KRISTA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
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:
1699841783
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/04/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
S 6TH AVE & SPR ST, READING HOSP REG CA CTR, BLDG N GR
Provider Second Line Business Mailing Address:
BERKS HEMATOLOGY ONCOLOGY ASSOC, LTD
Provider Business Mailing Address City Name:
WEST READING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19611-6052
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-374-4404
Provider Business Mailing Address Fax Number:
610-374-1396

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
S 6TH AVE & SPRUCE ST
Provider Second Line Business Practice Location Address:
READING HOSP REG CA CTR, BLDG N GROUND
Provider Business Practice Location Address City Name:
WEST READING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19611-6052
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-374-4404
Provider Business Practice Location Address Fax Number:
610-374-1396
Provider Enumeration Date:
11/28/2006

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: 363A00000X , with the licence number:  MA052783 , 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: 1958673 . This is a "HIGHMARK BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 50065627 . This is a "CAPITAL BLUE CROSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 50065627 . This is a "KEYSTONE HEALTH CENTRAL" identifier . This identifiers is of the category "OTHER".




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