1326868944 NPI number — DIANE MARGARET TABALAR MACAIBAY

Table of content: DIANE MARGARET TABALAR MACAIBAY (NPI 1326868944)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1326868944 NPI number — DIANE MARGARET TABALAR MACAIBAY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MACAIBAY
Provider First Name:
DIANE MARGARET
Provider Middle Name:
TABALAR
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1326868944
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/17/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PSC 561 BOX 1877
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
FPO
Provider Business Mailing Address State Name:
AP
Provider Business Mailing Address Postal Code:
96310-0019
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BLDG 110
Provider Second Line Business Practice Location Address:
MCAS IWAKUNI
Provider Business Practice Location Address City Name:
IWAKUNI
Provider Business Practice Location Address State Name:
YAMAGUCHI
Provider Business Practice Location Address Postal Code:
7400025
Provider Business Practice Location Address Country Code:
JP
Provider Business Practice Location Address Telephone Number:
315-255-8151
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/17/2024

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: 246Z00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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