1063877785 NPI number — MRS. RACHEL CATHERINE SWASEY CUEVAS OTR

Table of content: MRS. RACHEL CATHERINE SWASEY CUEVAS OTR (NPI 1063877785)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1063877785 NPI number — MRS. RACHEL CATHERINE SWASEY CUEVAS OTR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CUEVAS
Provider First Name:
RACHEL
Provider Middle Name:
CATHERINE SWASEY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
OTR
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SWASEY
Provider Other First Name:
RACHEL
Provider Other Middle Name:
CATHERINE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
OTR
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1063877785
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/22/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
42 OLD GORDON RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03833-6219
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-770-4204
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
42 OLD GORDON RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRENTWOOD
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03833-6219
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-770-4204
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/22/2015

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: 225X00000X , with the licence number:  2481 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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