1285720920 NPI number — MRS. MYRNA ROTHCHILD GILL LPCC OH E0000094

Table of content: MRS. MYRNA ROTHCHILD GILL LPCC OH E0000094 (NPI 1285720920)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285720920 NPI number — MRS. MYRNA ROTHCHILD GILL LPCC OH E0000094

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GILL
Provider First Name:
MYRNA
Provider Middle Name:
ROTHCHILD
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPCC OH E0000094
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:
1285720920
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
23360 CHAGRIN BOULEVARD
Provider Second Line Business Mailing Address:
102
Provider Business Mailing Address City Name:
BEACHWOOD
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44122-5537
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
216-591-1456
Provider Business Mailing Address Fax Number:
216-464-3131

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
23360 CHAGRIN BOULEVARD
Provider Second Line Business Practice Location Address:
102
Provider Business Practice Location Address City Name:
BEACHWOOD
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44122-5537
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
216-591-1456
Provider Business Practice Location Address Fax Number:
216-464-3131
Provider Enumeration Date:
10/04/2006

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: 101YP2500X , with the licence number:  PCC E0000094 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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