1295934149 NPI number — DR. BERTA M. MARCHAND PSYCHOLOGIST

Table of content: DR. BERTA M. MARCHAND PSYCHOLOGIST (NPI 1295934149)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295934149 NPI number — DR. BERTA M. MARCHAND PSYCHOLOGIST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARCHAND
Provider First Name:
BERTA
Provider Middle Name:
M.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYCHOLOGIST
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:
1295934149
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/12/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
LA COSTA APTS.
Provider Second Line Business Mailing Address:
330
Provider Business Mailing Address City Name:
FAJARDO
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00738-5160
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-414-7100
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CALLE CANADA #1324
Provider Second Line Business Practice Location Address:
ASSMCA SAN PATRICIO ANTIGUES HOSPITAL VETERANOS
Provider Business Practice Location Address City Name:
RIO PIEDRAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00928-1414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-783-8097
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/12/2007

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:  55 , 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)





Copyright © 2007-2025 www.npivalidator.com