1023100989 NPI number — MRS. VERONICA O. CANINO RN, MSN, NP-C

Table of content: MRS. VERONICA O. CANINO RN, MSN, NP-C (NPI 1023100989)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023100989 NPI number — MRS. VERONICA O. CANINO RN, MSN, NP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CANINO
Provider First Name:
VERONICA
Provider Middle Name:
O.
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN, MSN, NP-C
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:
1023100989
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
VETERANS AFFAIRS MEDICAL CENTER-PRIMARY CARE CLINIC
Provider Second Line Business Mailing Address:
1601 KIRKWOOD HIGHWAY
Provider Business Mailing Address City Name:
WILMINGTON
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19905
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-633-5454
Provider Business Mailing Address Fax Number:
302-633-5590

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
VETERANS AFFAIRS MEDICAL CENTER-PRIMARY CARE CLINIC
Provider Second Line Business Practice Location Address:
1601 KIRKWOOD HIGHWAY
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19905
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-633-5454
Provider Business Practice Location Address Fax Number:
302-633-5590
Provider Enumeration Date:
09/29/2006

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: 163W00000X , with the licence number:  RN299503L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 163W00000X , with the licence number: L1-0022948 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 363LF0000X , with the licence number: 26NN06938000 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 363LF0000X , with the licence number: VP004641B , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 363LF0000X , with the licence number: LG-0000206 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 163W00000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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