1912929639 NPI number — CENTER FOR OCCUPATIONAL AND ENVIRONMENTAL NEUROLOGY

Table of content: (NPI 1912929639)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1912929639 NPI number — CENTER FOR OCCUPATIONAL AND ENVIRONMENTAL NEUROLOGY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CENTER FOR OCCUPATIONAL AND ENVIRONMENTAL NEUROLOGY
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:
1912929639
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 HAMILL RD
Provider Second Line Business Mailing Address:
SUITE 225
Provider Business Mailing Address City Name:
BALTO
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21210-1815
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
413-433-2077
Provider Business Mailing Address Fax Number:
410-433-0622

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 HAMILL RD
Provider Second Line Business Practice Location Address:
SUITE 225
Provider Business Practice Location Address City Name:
BALTO
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21210-1815
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
413-433-2077
Provider Business Practice Location Address Fax Number:
410-433-0622
Provider Enumeration Date:
07/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HUFFMAN
Authorized Official First Name:
MARCIE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
ADMINISTRATOR
Authorized Official Telephone Number:
410-433-2077

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X , with the licence number:  D23424 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: T4310002 . This is a "BLUECHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: T4310002 . This is a "FEDERAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 11850 . This is a "JOHNS HOPKINS EMPLOYEE HE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 30396001 . This is a "CAREFIRST BLUECROSS BLUES" identifier . This identifiers is of the category "OTHER".
  • Identifier: T4310001 . This is a "CAREFIRST FEDERAL" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 2227527 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 328941901 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 240256 . This is a "MAMSI" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 4138503 NON HMO . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 0865690006 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 748305-29 . This is a "CAREFIRST BLUECROSS BLUESHIELD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: T4310001 . This is a "BLUECHOICE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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