1033106323 NPI number — MRS. SANDRA LEE KNAUER-KING MSW

Table of content: MRS. SANDRA LEE KNAUER-KING MSW (NPI 1033106323)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1033106323 NPI number — MRS. SANDRA LEE KNAUER-KING MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KNAUER-KING
Provider First Name:
SANDRA
Provider Middle Name:
LEE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
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:
1033106323
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/31/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
401 N BROAD ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MIDDLETOWN
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19709-1037
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-376-0621
Provider Business Mailing Address Fax Number:
302-376-6219

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
401 N BROAD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MIDDLETOWN
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19709-1037
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-376-0621
Provider Business Practice Location Address Fax Number:
302-376-6219
Provider Enumeration Date:
10/01/2005

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: 101YM0800X , with the licence number:  Q1-0000375 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000592373 , issued by the state of ( DE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 229576000 . This is a "MAGELLAN" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 2053830 . This is a "CIGNA" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 2265372000 . This is a "AMERIHEALTH" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 87726 . This is a "UBH" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 1000022284 . This is a "DELAWARE MEDICAID" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 246240 . This is a "COM PSYCH" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: M0120021 . This is a "CARE FIRST" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: N3H29 . This is a "EMPIRE BLUE CROSS" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 160505 . This is a "MENTAL HEALTH NET" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 00001661567 . This is a "INDEPENDENCE BLUE CROSS" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 001661567 . This is a "PERSONAL CHOICE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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