1134496813 NPI number — MRS. TRACEY MURPHY CITRANO

Table of content: MRS. TRACEY MURPHY CITRANO (NPI 1134496813)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1134496813 NPI number — MRS. TRACEY MURPHY CITRANO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CITRANO
Provider First Name:
TRACEY
Provider Middle Name:
MURPHY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MURPHY
Provider Other First Name:
TRACEY
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1134496813
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4938 BERRYHILL CIR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PERRY HALL
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21128-9109
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-458-6893
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7700 YORK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TOWSON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21204-7513
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-821-5500
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/22/2011

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: 235Z00000X , with the licence number:  06227 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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