1134437494 NPI number — MS. MIRELLA HERNANDEZ-PARBUS RPH

Table of content: MS. MIRELLA HERNANDEZ-PARBUS RPH (NPI 1134437494)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134437494 NPI number — MS. MIRELLA HERNANDEZ-PARBUS RPH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HERNANDEZ-PARBUS
Provider First Name:
MIRELLA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
RPH
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:
1134437494
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/21/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3573 HILLSBOROUGH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DURHAM
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27705
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
919-414-6853
Provider Business Mailing Address Fax Number:
919-383-0171

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3573 HILLSBOROUGH ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DURHAM
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27705
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
919-383-0171
Provider Business Practice Location Address Fax Number:
919-384-9641
Provider Enumeration Date:
09/21/2010

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: 183500000X , with the licence number:  14206 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 183500000X , with the licence number: 040233 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 14206 . This is a "NCBOP LICENSE NUMBER" identifier , issued by the state of ( NC ) . This identifiers is of the category "OTHER".




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