1932139342 NPI number — JAMIE F ALTMAN MD

Table of content: JAMIE F ALTMAN MD (NPI 1932139342)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932139342 NPI number — JAMIE F ALTMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALTMAN
Provider First Name:
JAMIE
Provider Middle Name:
F
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1932139342
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/20/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
176 S NEW MIDDLETOWN RD STE 203
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MEDIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19063-5255
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-566-7300
Provider Business Mailing Address Fax Number:
610-891-8973

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
176 S NEW MIDDLETOWN RD STE 203
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MEDIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19063
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-566-7300
Provider Business Practice Location Address Fax Number:
610-891-8973
Provider Enumeration Date:
07/03/2006

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: 207N00000X , with the licence number:  MD421271 , 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: 2149419000 . This is a "AMERIHEALTH HMO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 001465172 . This is a "BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1465172 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2149419000 . This is a "IBC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 001465172 . This is a "AMERIHEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 001465172 . This is a "PERSONAL CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 3473388 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00128279 . This is a "MEDICARE RAILROAD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 209082 . This is a "COVENTRY HMO AND PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 065172 . This is a "AMERIHEALTH BLAIR MILL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2149419000 . This is a "KEYSTONE EAST AND 65 ONLY" identifier . This identifiers is of the category "OTHER".




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