1164862355 NPI number — MISS JENILEE APRIL MARY GENERALLA M.D.

Table of content: MISS JENILEE APRIL MARY GENERALLA M.D. (NPI 1164862355)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1164862355 NPI number — MISS JENILEE APRIL MARY GENERALLA M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GENERALLA
Provider First Name:
JENILEE
Provider Middle Name:
APRIL MARY
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1164862355
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/02/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 UNIVERSITY DRIVE
Provider Second Line Business Mailing Address:
DEPARTMENT OF PSYCHIATRY, H073, C5600
Provider Business Mailing Address City Name:
HERSHEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17033-0850
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-531-0003
Provider Business Mailing Address Fax Number:
717-531-6491

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 UNIVERSITY DRIVE
Provider Second Line Business Practice Location Address:
DEPARTMENT OF PSYCHIATRY, H073, C5600
Provider Business Practice Location Address City Name:
HERSHEY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17033-0850
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-531-0003
Provider Business Practice Location Address Fax Number:
717-531-6491
Provider Enumeration Date:
07/02/2013

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2025 www.npivalidator.com