1871588970 NPI number — DENISE RANUCCI MD,LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871588970 NPI number — DENISE RANUCCI MD,LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DENISE RANUCCI MD,LLC
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:
1871588970
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/23/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
714 DAVENTRY LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AMBLER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19002-2307
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-657-5903
Provider Business Mailing Address Fax Number:
215-657-5905

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
303 HORSHAM RD
Provider Second Line Business Practice Location Address:
SUITE 1B
Provider Business Practice Location Address City Name:
HORSHAM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19044-2029
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-657-5903
Provider Business Practice Location Address Fax Number:
215-657-5905
Provider Enumeration Date:
09/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
RANUCCI
Authorized Official First Name:
DENISE
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PRESIDENT/PHYSICIAN
Authorized Official Telephone Number:
215-657-5903

Provider Taxonomy Codes

  • Taxonomy code: 207VG0400X , with the licence number:  MD056740L , 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: 2295165000 . This is a "KEYSTONE99" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2295165000 . This is a "INDEPENDANCE BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 458533000 . This is a "AMERIHEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P1262777 . This is a "OXFORD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3550319 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 620582 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1613426 . This is a "HIGHMARK BCBS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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