1285307371 NPI number — 1ON1PSYCHIATRY

Table of content: (NPI 1285307371)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285307371 NPI number — 1ON1PSYCHIATRY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
1ON1PSYCHIATRY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1285307371
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/26/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1309 MCKINLEY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JEFFERSON HILLS
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15025-2736
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-951-7599
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1309 MCKINLEY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JEFFERSON HILLS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15025-2736
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-951-7599
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/26/2021

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
RECHTER
Authorized Official First Name:
SHARON
Authorized Official Middle Name:
GAIL
Authorized Official Title or Position:
PSYCHIATRIST
Authorized Official Telephone Number:
412-951-7599

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 01534898 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1225089659 . This is a "PSYCHIATRY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".