1811947054 NPI number — REGIONAL HEMATOLOGY AND ONCOLOGY P A

Table of content: (NPI 1811947054)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1811947054 NPI number — REGIONAL HEMATOLOGY AND ONCOLOGY P A

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
REGIONAL HEMATOLOGY AND ONCOLOGY P A
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:
1811947054
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/16/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4701 OGLETOWN STANTON RD
Provider Second Line Business Mailing Address:
SUITE 2400
Provider Business Mailing Address City Name:
NEWARK
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19713-2055
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-731-7782
Provider Business Mailing Address Fax Number:
302-738-5917

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4701 OGLETOWN STANTON RD
Provider Second Line Business Practice Location Address:
SUITE 2400
Provider Business Practice Location Address City Name:
NEWARK
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19713-2055
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-731-7782
Provider Business Practice Location Address Fax Number:
302-738-5917
Provider Enumeration Date:
05/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KHATRI
Authorized Official First Name:
JAMIL
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
302-731-7782

Provider Taxonomy Codes

  • Taxonomy code: 207RH0003X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0014680590008 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 432121905 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0000146902 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com