1962595520 NPI number — JULIA HEYA KARCIC D.P.M.

Table of content: KENNETH WAYNE MILLER PT (NPI 1134522188)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962595520 NPI number — JULIA HEYA KARCIC D.P.M.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JULIA HEYA KARCIC D.P.M.
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:
1962595520
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2735 CENTRAL ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NATRONA HEIGHTS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15065-1726
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-224-3255
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1005 LANE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NATRONA HEIGHTS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15065-1340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-224-3255
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
KARCIC
Authorized Official First Name:
JULIA
Authorized Official Middle Name:
HEYA
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
724-224-3255

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  SC003624L , 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: 053164 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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