1912057175 NPI number — MRS. DIANE MARIE LADDBUSH LECOMPTE

Table of content: MRS. DIANE MARIE LADDBUSH LECOMPTE (NPI 1912057175)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912057175 NPI number — MRS. DIANE MARIE LADDBUSH LECOMPTE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LADDBUSH LECOMPTE
Provider First Name:
DIANE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
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:
1912057175
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
26883 RIVER ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SEAFORD
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19973
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-629-2249
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 SWAIN ROAD
Provider Second Line Business Practice Location Address:
FREDERICK DOUGLASS ELEMENTARY SEAFORD SCHOOL DISTRICT
Provider Business Practice Location Address City Name:
SEAFORD
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19973
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-628-4413
Provider Business Practice Location Address Fax Number:
302-628-4486
Provider Enumeration Date:
01/11/2007

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: 235Z00000X , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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