1962777326 NPI number — JEANNE-MARIE SINNOTT D.O.

Table of content: JEANNE-MARIE SINNOTT D.O. (NPI 1962777326)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962777326 NPI number — JEANNE-MARIE SINNOTT D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SINNOTT
Provider First Name:
JEANNE-MARIE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
D.O.
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:
1962777326
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/04/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2865 N REYNOLDS RD
Provider Second Line Business Mailing Address:
SUITE 140
Provider Business Mailing Address City Name:
TOLEDO
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43615-2068
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-578-7590
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2865 N REYNOLDS RD
Provider Second Line Business Practice Location Address:
SUITE 140
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43615-2068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-578-7590
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/19/2012

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: 207QS0010X , with the licence number:  011843 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207Q00000X , with the licence number: 20A12937 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 390200000X . This is a "STUDENT IN AN ORGANIZED HEALTH CARE EDUCATION/TRAINING" identifier , issued by the state of ( CA ) . This identifiers is of the category "OTHER".




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