1225120868 NPI number — DR. MAUREENRITA O'TOOLE WORK D.C.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225120868 NPI number — DR. MAUREENRITA O'TOOLE WORK D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WORK
Provider First Name:
MAUREENRITA
Provider Middle Name:
O'TOOLE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
O'TOOLE
Provider Other First Name:
MAUREEN
Provider Other Middle Name:
RITA
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1225120868
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/21/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5919 JAMES ST
Provider Second Line Business Mailing Address:
SUITE C
Provider Business Mailing Address City Name:
CLEMMONS
Provider Business Mailing Address State Name:
NC
Provider Business Mailing Address Postal Code:
27012-9688
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
336-766-3993
Provider Business Mailing Address Fax Number:
336-766-3991

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5919 JAMES ST
Provider Second Line Business Practice Location Address:
SUITE C
Provider Business Practice Location Address City Name:
CLEMMONS
Provider Business Practice Location Address State Name:
NC
Provider Business Practice Location Address Postal Code:
27012-9688
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
336-766-3993
Provider Business Practice Location Address Fax Number:
336-766-3991
Provider Enumeration Date:
09/29/2006

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: 111N00000X , with the licence number:  3467 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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