1255385845 NPI number — TATJANA N SLJAPIC MD

Table of content: TATJANA N SLJAPIC MD (NPI 1255385845)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255385845 NPI number — TATJANA N SLJAPIC MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SLJAPIC
Provider First Name:
TATJANA
Provider Middle Name:
N
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1255385845
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/22/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
LANCASTER MEDICAL CENTER CARDIOLOGY
Provider Second Line Business Mailing Address:
2160 STATE ROAD,SUITE 1700
Provider Business Mailing Address City Name:
LANCASTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
223-287-8155
Provider Business Mailing Address Fax Number:
717-312-3153

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
802 NEW HOLLAND AVE
Provider Second Line Business Practice Location Address:
SUITE 200
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17602-2163
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-291-0700
Provider Business Practice Location Address Fax Number:
717-291-9634
Provider Enumeration Date:
05/19/2006

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: 204R00000X , with the licence number:  MD062866L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0000X , with the licence number: MD062866L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207RC0001X , with the licence number: MD062866L , 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: 001892270 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com