1265702708 NPI number — ARELIS JANET ROMAN-PAGAN M.A.

Table of content: ARELIS JANET ROMAN-PAGAN M.A. (NPI 1265702708)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1265702708 NPI number — ARELIS JANET ROMAN-PAGAN M.A.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROMAN-PAGAN
Provider First Name:
ARELIS
Provider Middle Name:
JANET
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.A.
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:
1265702708
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/30/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 283
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SABANA HOYOS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00688-0283
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-344-8352
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BARRIO SABANA HOYOS SECTOR CAROLINA
Provider Second Line Business Practice Location Address:
CARR 2 R 639 KM 6.0
Provider Business Practice Location Address City Name:
SABANA HOYOS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00688
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-344-8352
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/30/2011

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: 103T00000X , with the licence number:  4195 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 4195 . This is a "LICENCIA DE PSICOLOGA" identifier , issued by the state of ( PR ) . This identifiers is of the category "OTHER".




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