1073868014 NPI number — HEATHER MICHELLE LAMPE PT, DPT

Table of content: HEATHER MICHELLE LAMPE PT, DPT (NPI 1073868014)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073868014 NPI number — HEATHER MICHELLE LAMPE PT, DPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAMPE
Provider First Name:
HEATHER
Provider Middle Name:
MICHELLE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT, DPT
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:
1073868014
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/27/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6410 ROCKLEDGE DR
Provider Second Line Business Mailing Address:
STE 301
Provider Business Mailing Address City Name:
BETHESDA
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20817-1841
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-897-0357
Provider Business Mailing Address Fax Number:
301-897-2148

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
211 S GULPH RD
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
KING OF PRUSSIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19406-3112
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-265-2230
Provider Business Practice Location Address Fax Number:
610-265-2240
Provider Enumeration Date:
07/16/2012

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: 225100000X , with the licence number:  28527 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225100000X , with the licence number: PT022146 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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