1194701797 NPI number — MRS. SHERYL MICHELLE DRONEY MPT MTC

Table of content: ANNIE MARIE TAPPY (NPI 1396456224)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194701797 NPI number — MRS. SHERYL MICHELLE DRONEY MPT MTC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DRONEY
Provider First Name:
SHERYL
Provider Middle Name:
MICHELLE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MPT MTC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LADRECH
Provider Other First Name:
SHERLY
Provider Other Middle Name:
MICHELLE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MPT MTC
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1194701797
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:
3132 NYS ROUTE 417
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OLEAN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
14760
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
716-372-6787
Provider Business Mailing Address Fax Number:
716-372-3747

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3132 NYS ROUTE 417
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
OLEAN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14760
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
716-372-6787
Provider Business Practice Location Address Fax Number:
716-372-3747
Provider Enumeration Date:
12/16/2005

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:  019113 , 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)

  • Identifier: 00062551003 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 01955297 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9310979 . This is a "INDEPENDENT HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00199541 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 00026486701 . This is a "UNIVERA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 6697640 . This is a "GHI" identifier . This identifiers is of the category "OTHER".




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