1720621410 NPI number — CYNTHIA E PAWLOWICZ APRN

Table of content: CHRISTOPHER RAPHAEL RETTENMAIER MD (NPI 1497119234)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720621410 NPI number — CYNTHIA E PAWLOWICZ APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PAWLOWICZ
Provider First Name:
CYNTHIA
Provider Middle Name:
E
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHEBATOR
Provider Other First Name:
CYNTHIA
Provider Other Middle Name:
E
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
APRN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1720621410
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/06/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
16 HOSPITAL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PLYMOUTH
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03264-1199
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-238-2229
Provider Business Mailing Address Fax Number:
603-536-3256

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
16 HOSPITAL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PLYMOUTH
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03264-1199
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-238-2229
Provider Business Practice Location Address Fax Number:
603-536-3256
Provider Enumeration Date:
10/24/2019

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: 363L00000X , with the licence number:  068762-23 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 225256 . This is a "REGISTERED NURSE PRACTITIONER" identifier , issued by the state of ( AZ ) . This identifiers is of the category "OTHER".
  • Identifier: 068762-23 . This is a "LICENSE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".