1962800888 NPI number — OFICINA DEL PROCURADOR DE LAS PERSONAS DE EDAD AVANZADA DEL ELA

Table of content: (NPI 1962800888)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962800888 NPI number — OFICINA DEL PROCURADOR DE LAS PERSONAS DE EDAD AVANZADA DEL ELA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
OFICINA DEL PROCURADOR DE LAS PERSONAS DE EDAD AVANZADA DEL ELA
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:
1962800888
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/09/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 191179
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:
00919-1179
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-721-6121
Provider Business Mailing Address Fax Number:
787-919-7288

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1064 AVE. PONCE DE LEON 3RD FLOOR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAN JUAN
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00919
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-721-6121
Provider Business Practice Location Address Fax Number:
787-919-7288
Provider Enumeration Date:
12/09/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
SANCHEZ SALGADO
Authorized Official First Name:
CARMEN
Authorized Official Middle Name:
D
Authorized Official Title or Position:
PROCURADORA
Authorized Official Telephone Number:
787-721-6121

Provider Taxonomy Codes

  • Taxonomy code: 253Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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