1225025299 NPI number — DR. JOHN SILIQUINI SR. M.D.

Table of content: DR. JOHN SILIQUINI SR. M.D. (NPI 1225025299)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225025299 NPI number — DR. JOHN SILIQUINI SR. M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SILIQUINI
Provider First Name:
JOHN
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
SR.
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1225025299
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/04/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
50 WELSH RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HUNTINGDON VALLEY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19006-6746
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-331-8436
Provider Business Mailing Address Fax Number:
215-338-0167

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9126 BLUE GRASS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19114-3202
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-331-0992
Provider Business Practice Location Address Fax Number:
215-338-0167
Provider Enumeration Date:
10/04/2005

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: 207W00000X , with the licence number:  MD027938L , 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)

  • Identifier: 3633763 . This is a "AETNA INDIVIDUAL ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1277626 . This is a "CIGNA INDIVIDUAL ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: P00143982 . This is a "RR MEDICARE INDIVIDUAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 000647959 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0053391000 . This is a "IBC INDIVIDUAL ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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