1376504993 NPI number — DR. NYDIA I. SEPULVEDA-PAGAN II MD

Table of content: DR. NYDIA I. SEPULVEDA-PAGAN II MD (NPI 1376504993)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376504993 NPI number — DR. NYDIA I. SEPULVEDA-PAGAN II MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEPULVEDA-PAGAN
Provider First Name:
NYDIA
Provider Middle Name:
I.
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
II
Provider Credential Text:
MD
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:
1376504993
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/08/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
CARR. 135 KM. 70.2
Provider Second Line Business Mailing Address:
BO. YAHUECAS
Provider Business Mailing Address City Name:
ADJUNTAS
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00601-9711
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-829-0824
Provider Business Mailing Address Fax Number:
787-597-6372

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
CARR 135 KM 70.2
Provider Second Line Business Practice Location Address:
BO. YAHUECAS
Provider Business Practice Location Address City Name:
ADJUNTAS
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00601-9711
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-829-0824
Provider Business Practice Location Address Fax Number:
787-597-6372
Provider Enumeration Date:
03/31/2006

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: 207Q00000X , with the licence number:  15427 , 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