1922067008 NPI number — MRS. CLAIRE S VATZ SLP MA CCC

Table of content: REGINA LARA L.P.N. (NPI 1962642058)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922067008 NPI number — MRS. CLAIRE S VATZ SLP MA CCC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
VATZ
Provider First Name:
CLAIRE
Provider Middle Name:
S
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
SLP MA CCC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SANTAGATI
Provider Other First Name:
CLAIRE
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
SLP MA CCC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1922067008
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:
1374 TERRACE DRIVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15228
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-343-7006
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
250 MT LEBANON BOULEVARD
Provider Second Line Business Practice Location Address:
STE 411
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15234
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-563-2434
Provider Business Practice Location Address Fax Number:
412-563-7610
Provider Enumeration Date:
03/20/2006

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: 235Z00000X , with the licence number:  SL000364L , 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: 77821 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 9843422 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2270753 . This is a "AETNA" identifier , issued by the state of ( TX ) . This identifiers is of the category "OTHER".
  • Identifier: 35471 . This is a "HEALTH AMERICA ASSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 104027 . This is a "UPHC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 466014 . This is a "HIGHMARK VA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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