1356984629 NPI number — AMY EPTING MA, RD, LDN

Table of content: AMY EPTING MA, RD, LDN (NPI 1356984629)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356984629 NPI number — AMY EPTING MA, RD, LDN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
EPTING
Provider First Name:
AMY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MA, RD, LDN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EPTING
Provider Other First Name:
AMY
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA, RD, LDN
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1356984629
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/19/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
460 BERNE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19526-8917
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-207-1737
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2485 ZERBE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NARVON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17555-9328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-445-8741
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/19/2019

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: 133V00000X , with the licence number:  933987 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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