1184686198 NPI number — ROSLYN ZINNER LCSW C MSW

Table of content: ROSLYN ZINNER LCSW C MSW (NPI 1184686198)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184686198 NPI number — ROSLYN ZINNER LCSW C MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ZINNER
Provider First Name:
ROSLYN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LCSW C MSW
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:
1184686198
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8288 TELEGRAPH RD
Provider Second Line Business Mailing Address:
SUITE A
Provider Business Mailing Address City Name:
ODENTON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21113-1130
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-672-2237
Provider Business Mailing Address Fax Number:
410-695-6038

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8288 TELEGRAPH RD
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
ODENTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21113-1130
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-672-2237
Provider Business Practice Location Address Fax Number:
410-695-6038
Provider Enumeration Date:
04/05/2006

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: 1041C0700X , with the licence number:  02679 , 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)

  • Identifier: 128207 . This is a "VALUE OPTIONS AND GREAT W" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4347247 . This is a "AETNA BEHAVIORAL HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 47474 . This is a "MAMSI UNITED HEALTH CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 513270 . This is a "NCPPO INNOVA MHIP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 52253405 . This is a "BLUE SHIELD OF MD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0006 . This is a "BLUE SHIELD FEDERAL" identifier . This identifiers is of the category "OTHER".
  • Identifier: 162197 . This is a "MHN AND TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10764419 . This is a "CAQH" identifier . This identifiers is of the category "OTHER".
  • Identifier: S003 . This is a "BLUE SHIELD FEDERAL GROUP" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com