1154516607 NPI number — MISS GINGER ELIZABETH RIEBE NPP

Table of content: MISS GINGER ELIZABETH RIEBE NPP (NPI 1154516607)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154516607 NPI number — MISS GINGER ELIZABETH RIEBE NPP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RIEBE
Provider First Name:
GINGER
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
NPP
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:
1154516607
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/07/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 10
Provider Second Line Business Mailing Address:
WOODS ROAD, GRASSLANDS RESERVATION
Provider Business Mailing Address City Name:
VALHALLA
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10595-0010
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-231-1356
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
DEPT OF CORRECTIONS- WOODS ROAD
Provider Second Line Business Practice Location Address:
GRASSLANDS RESERVATION
Provider Business Practice Location Address City Name:
VALHALLA
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10595-0010
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
914-231-1356
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/07/2007

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: 363LP0808X , with the licence number:  F400588 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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