1295548824 NPI number — MARIE ELAINA PANGILINAN NBC-WHC

Table of content: MARIE ELAINA PANGILINAN NBC-WHC (NPI 1295548824)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295548824 NPI number — MARIE ELAINA PANGILINAN NBC-WHC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PANGILINAN
Provider First Name:
MARIE
Provider Middle Name:
ELAINA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NBC-WHC
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:
1295548824
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/28/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
232 LAKE CHAMPLAIN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LITTLE EGG HARBOR TWP
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08087-1743
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-773-7548
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
820 BEAR TAVERN ROAD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WEST TRENTON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08628-1021
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-538-1818
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/28/2025

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: 171400000X , registered in the state of NJ ; 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