1205021763 NPI number — ERLINDA M SINGARAJAH ANP-C

Table of content: ERLINDA M SINGARAJAH ANP-C (NPI 1205021763)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205021763 NPI number — ERLINDA M SINGARAJAH ANP-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SINGARAJAH
Provider First Name:
ERLINDA
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ANP-C
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:
1205021763
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/15/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5000 E MCDOWELL RD
Provider Second Line Business Mailing Address:
MC M520-H162
Provider Business Mailing Address City Name:
MESA
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85215-9707
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
480-891-4142
Provider Business Mailing Address Fax Number:
480-891-8100

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5000 E MCDOWELL RD
Provider Second Line Business Practice Location Address:
MC M520-H162
Provider Business Practice Location Address City Name:
MESA
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85215-9707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-891-4142
Provider Business Practice Location Address Fax Number:
480-891-8101
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: 207Q00000X , with the licence number:  RN070264 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X , with the licence number: AP2852 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 254850 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".




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