1275507675 NPI number — JOHN JAMES FIRPO MD

Table of content: JOHN JAMES FIRPO MD (NPI 1275507675)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275507675 NPI number — JOHN JAMES FIRPO MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FIRPO
Provider First Name:
JOHN
Provider Middle Name:
JAMES
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1275507675
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/23/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
510 W DARBY RD
Provider Second Line Business Mailing Address:
2ND FLOOR
Provider Business Mailing Address City Name:
HAVERTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19083-4630
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-789-6320
Provider Business Mailing Address Fax Number:
610-789-6325

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
510 W DARBY RD
Provider Second Line Business Practice Location Address:
2ND FLOOR
Provider Business Practice Location Address City Name:
HAVERTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19083-4630
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-789-6320
Provider Business Practice Location Address Fax Number:
610-789-6325
Provider Enumeration Date:
02/14/2006

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: 207RN0300X , with the licence number:  MD014158E , 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: 0007157810001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 30926A . This is a "KEYSTONE MERCY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0032976000 . This is a "IBC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 02191MD014158E . This is a "HEALTH PARNTERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 121206 . This is a "HIGHMARK BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 390001500 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0071578102 . This is a "AMERICHOICE OF PA" identifier . This identifiers is of the category "OTHER".
  • Identifier: MD014158E . This is a "MEDIAL LICENSE NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 4100579 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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