1992090781 NPI number — NAAMAN CENTER

Table of content: MICHELLE M ROIGER M.D. (NPI 1295762896)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1992090781 NPI number — NAAMAN CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
NAAMAN CENTER
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:
1992090781
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4600 E HARRISBURG PIKE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ELIZABETHTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17022-9004
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-367-9115
Provider Business Mailing Address Fax Number:
717-367-9759

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
835 HOUSTON RUN DR STE 230
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GAP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17527-9489
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
888-243-4316
Provider Business Practice Location Address Fax Number:
717-367-9759
Provider Enumeration Date:
06/09/2011

Additional Information

Authorized Official

Authorized Official Last Name:
FRANK
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
717-367-9115

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X , with the licence number:  367085 , 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: 100776805004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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