1164788428 NPI number — THERESA MEGAN HOOD MPT

Table of content: DR. CHARLES P REZNIKOFF MD (NPI 1013952175)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164788428 NPI number — THERESA MEGAN HOOD MPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HOOD
Provider First Name:
THERESA
Provider Middle Name:
MEGAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MPT
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GUINAN
Provider Other First Name:
THERESA
Provider Other Middle Name:
MEGAN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MPT
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1164788428
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/19/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2301 HUNTINGDON PIKE
Provider Second Line Business Mailing Address:
SUITE 100
Provider Business Mailing Address City Name:
HUNTINGDON VALLEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19006-6130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-947-6262
Provider Business Mailing Address Fax Number:
215-947-0212

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2301 HUNTINGDON PIKE
Provider Second Line Business Practice Location Address:
SUITE 100
Provider Business Practice Location Address City Name:
HUNTINGDON VALLEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19006-6130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-947-6262
Provider Business Practice Location Address Fax Number:
215-947-0212
Provider Enumeration Date:
04/11/2012

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:  PT019043 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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