1942405519 NPI number — PHILIP ORENSTEIN PT

Table of content: PHILIP ORENSTEIN PT (NPI 1942405519)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942405519 NPI number — PHILIP ORENSTEIN PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ORENSTEIN
Provider First Name:
PHILIP
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT
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:
1942405519
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/21/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4999 FRANCE AVE S
Provider Second Line Business Mailing Address:
SUITE 235
Provider Business Mailing Address City Name:
MINNEAPOLIS
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55410-1703
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
612-333-1133
Provider Business Mailing Address Fax Number:
612-333-0033

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4999 FRANCE AVE S
Provider Second Line Business Practice Location Address:
SUITE 235
Provider Business Practice Location Address City Name:
MINNEAPOLIS
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55410-1703
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
612-333-1133
Provider Business Practice Location Address Fax Number:
612-333-0033
Provider Enumeration Date:
06/15/2007

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: 225100000X , with the licence number:  2384 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1730178005 . This is a "CORP NPI" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 411912266 . This is a "TAX ID NO" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 6482096 . This is a "MEDICA ID NO" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 58063 . This is a "HP ID NO" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 29B68OR . This is a "BCBS GROUP NO" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 29B69OR . This is a "BCBS ID#" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 85641 . This is a "PREONE ID NO" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: $$$$$$$$$ . This is a "SOCIAL SECURITY #" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".
  • Identifier: 411912266 . This is a "TAX ID:" identifier , issued by the state of ( MN ) . This identifiers is of the category "OTHER".




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