1063871846 NPI number — KNOPF RADIOLOGY AND HEALTH SERVICES

Table of content: (NPI 1063871846)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063871846 NPI number — KNOPF RADIOLOGY AND HEALTH SERVICES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KNOPF RADIOLOGY AND HEALTH SERVICES
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:
1063871846
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/22/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
634 E CHESTER PIKE
Provider Second Line Business Mailing Address:
APT F 1
Provider Business Mailing Address City Name:
RIDLEY PARK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19078-1731
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-470-5627
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
634 E,CHESTER PIKE
Provider Second Line Business Practice Location Address:
APT F 1
Provider Business Practice Location Address City Name:
RIDLEY PARK
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19078
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-470-5627
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/22/2016

Additional Information

Authorized Official

Authorized Official Last Name:
OGOGO
Authorized Official First Name:
ZUDDY
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGING DIRECTOR
Authorized Official Telephone Number:
484-470-5627

Provider Taxonomy Codes

  • Taxonomy code: 261QR0208X , with the licence number:  6352517 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251S00000X , with the licence number: 6352517 , 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)





Copyright © 2007-2025 www.npivalidator.com