1255498416 NPI number — DR. SANDRA BWINT OD

Table of content: DR. SANDRA BWINT OD (NPI 1255498416)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1255498416 NPI number — DR. SANDRA BWINT OD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BWINT
Provider First Name:
SANDRA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
OD
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:
1255498416
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
936 BALTIMORE PIKE, SUITE 2
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GLEN MILLS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19342-1022
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-239-1933
Provider Business Mailing Address Fax Number:
412-204-7923

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
936 BALTIMORE PIKE STE 2
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GLEN MILLS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19342-1380
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-239-1933
Provider Business Practice Location Address Fax Number:
412-204-7923
Provider Enumeration Date:
01/03/2007

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: 152W00000X , with the licence number:  OET009158 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 27OA0047900 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: OE006708P , 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)





Copyright © 2007-2025 www.npivalidator.com