1922087469 NPI number — LEIGH A BEARS ARNP

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 1922087469 NPI number — LEIGH A BEARS ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BEARS
Provider First Name:
LEIGH
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
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:
1922087469
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
276 NEWPORT RD
Provider Second Line Business Mailing Address:
SUITE 107
Provider Business Mailing Address City Name:
NEW LONDON
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03257-5468
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-526-4144
Provider Business Mailing Address Fax Number:
603-526-4167

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
541 MAIN ST
Provider Second Line Business Practice Location Address:
BAIRD HEALTH AND COUNSELING CENTER
Provider Business Practice Location Address City Name:
NEW LONDON
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03257-7818
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-526-3621
Provider Business Practice Location Address Fax Number:
603-526-3453
Provider Enumeration Date:
01/12/2006

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: 363LF0000X , with the licence number:  044747-23-03 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 113658427 . This is a "GREAT WEST" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 23YP02921NH01 . This is a "ANTHEM" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: P30444 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 30009297 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 113658427 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".
  • Identifier: 3339588 . This is a "CIGNA" identifier , issued by the state of ( NH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com