1932453669 NPI number — CARLOS ALBIZU UNIVERSITY

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 1932453669 NPI number — CARLOS ALBIZU UNIVERSITY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CARLOS ALBIZU UNIVERSITY
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:
1932453669
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/02/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 9023711
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00902-3711
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-725-6500
Provider Business Mailing Address Fax Number:
787-721-7187

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE TANCA 151 ESQUINA SAN FRANCISCO
Provider Second Line Business Practice Location Address:
VIEJO SAN JUAN
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-725-6500
Provider Business Practice Location Address Fax Number:
787-721-7183
Provider Enumeration Date:
11/02/2012

Additional Information

Authorized Official

Authorized Official Last Name:
LOPEZ-CORDOVA
Authorized Official First Name:
NANET
Authorized Official Middle Name:
MARIE
Authorized Official Title or Position:
PSYD PROGRAM DIRECTOR
Authorized Official Telephone Number:
787-725-6500

Provider Taxonomy Codes

  • Taxonomy code: 103TC0700X , with the licence number:  1206 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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