1821026741 NPI number — JAMES C BRANN RN MSN CS

Table of content: JOAN JUNGHANS PTA (NPI 1831690080)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821026741 NPI number — JAMES C BRANN RN MSN CS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BRANN
Provider First Name:
JAMES
Provider Middle Name:
C
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN MSN CS
Provider Gender Code:
M

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:
1821026741
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/22/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1578 OLD YORK RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ABINGTON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19001-1709
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-830-8460
Provider Business Mailing Address Fax Number:
215-830-8464

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1578 OLD YORK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ABINGTON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19001-1709
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-830-8460
Provider Business Practice Location Address Fax Number:
215-830-8464
Provider Enumeration Date:
06/29/2006

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: 163WP0808X , with the licence number:  RN270786L , 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: 000819785 . This is a "HIGHMARK BC/BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0007066181 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0849884000 . This is a "PERSONAL CHOICE NETWORK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 268899000 . This is a "MAGELLAN BEHAVIORAHEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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