1336334473 NPI number — MRS. KRISTY ALTONGY-MAGEE PA-C

Table of content: MRS. KRISTY ALTONGY-MAGEE PA-C (NPI 1336334473)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336334473 NPI number — MRS. KRISTY ALTONGY-MAGEE PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALTONGY-MAGEE
Provider First Name:
KRISTY
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
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:
1336334473
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/14/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 16149
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
RUMFORD
Provider Business Mailing Address State Name:
RI
Provider Business Mailing Address Postal Code:
02916-0697
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
401-453-9625
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
164 SUMMIT AVE
Provider Second Line Business Practice Location Address:
ROOM C70
Provider Business Practice Location Address City Name:
PROVIDENCE
Provider Business Practice Location Address State Name:
RI
Provider Business Practice Location Address Postal Code:
02906-2853
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
401-793-3922
Provider Business Practice Location Address Fax Number:
401-435-7069
Provider Enumeration Date:
09/12/2007

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: 363AM0700X , with the licence number:  PA2466 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363AS0400X , with the licence number: PA00475 , registered in the state of RI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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