1780829093 NPI number — POCONO INFECTIOUS DISEASES

Table of content: DR. ASHLEY LEILANI PERKINS DMD (NPI 1376197343)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780829093 NPI number — POCONO INFECTIOUS DISEASES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
POCONO INFECTIOUS DISEASES
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1780829093
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/04/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
206 E BROWN ST
Provider Second Line Business Mailing Address:
POCONO HEALTHCARE MANANGEMENT. - PROFESSIONAL CENTER
Provider Business Mailing Address City Name:
EAST STROUDSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18301-3006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-420-4951
Provider Business Mailing Address Fax Number:
570-476-3754

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
285 PROSPECT ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EAST STROUDSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18301-2943
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-426-2301
Provider Business Practice Location Address Fax Number:
570-426-2306
Provider Enumeration Date:
12/16/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RAGONE
Authorized Official First Name:
JANE
Authorized Official Middle Name:
Authorized Official Title or Position:
MANANGER
Authorized Official Telephone Number:
570-420-4970

Provider Taxonomy Codes

  • Taxonomy code: 207RI0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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