1922059518 NPI number — DINA M DELDON-SALTIN DO

Table of content: DINA M DELDON-SALTIN DO (NPI 1922059518)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922059518 NPI number — DINA M DELDON-SALTIN DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DELDON-SALTIN
Provider First Name:
DINA
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
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:
1922059518
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/14/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
328 SHREWSBURY ST
Provider Second Line Business Mailing Address:
STE 100
Provider Business Mailing Address City Name:
WORCESTER
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
01604-4613
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-755-4861
Provider Business Mailing Address Fax Number:
508-752-1392

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
328 SHREWSBURY ST
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
WORCESTER
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
01604-4613
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-755-4861
Provider Business Practice Location Address Fax Number:
508-752-1392
Provider Enumeration Date:
05/16/2006

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: 207V00000X , with the licence number:  223516 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0035726 . This is a "NEIGHBORHOOD HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 96092 . This is a "FALLON" identifier . This identifiers is of the category "OTHER".
  • Identifier: J29208 . This is a "BCBS OF MA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: AA38773 . This is a "HARVARD PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2105713 , issued by the state of ( MA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 478732 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com