1851665715 NPI number — MS. LORI KONITSKY CHAPLICK M.A.

Table of content: MS. LORI KONITSKY CHAPLICK M.A. (NPI 1851665715)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1851665715 NPI number — MS. LORI KONITSKY CHAPLICK M.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CHAPLICK
Provider First Name:
LORI
Provider Middle Name:
KONITSKY
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.A.
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:
1851665715
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/29/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
50 MOORENOLL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCHUYLKILL HAVEN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17972-2019
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-385-1304
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5 S CENTRE AVE
Provider Second Line Business Practice Location Address:
SUITE A5
Provider Business Practice Location Address City Name:
LEESPORT
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19533-8653
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-939-8429
Provider Business Practice Location Address Fax Number:
610-926-9179
Provider Enumeration Date:
02/23/2012

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: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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