1376543314 NPI number — DR. MARCELA BOHM-VELEZ M.D.

Table of content: DR. MARCELA BOHM-VELEZ M.D. (NPI 1376543314)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1376543314 NPI number — DR. MARCELA BOHM-VELEZ M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BOHM-VELEZ
Provider First Name:
MARCELA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
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:
1376543314
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1910 COCHRAN RD
Provider Second Line Business Mailing Address:
MANOR OAK TWO, SUITE 740
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15220-1203
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-440-6999
Provider Business Mailing Address Fax Number:
412-440-6998

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1910 COCHRAN RD
Provider Second Line Business Practice Location Address:
MANOR OAK TWO, SUITE 740
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15220-1203
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-440-6999
Provider Business Practice Location Address Fax Number:
412-440-6998
Provider Enumeration Date:
07/29/2005

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: 2085R0202X , with the licence number:  MD027358E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2085U0001X , with the licence number: MD027358E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 0004084978 . This is a "AETNA ID #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: B0155322 . This is a "HIGHMARK ID #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 16553 . This is a "HEALTH AMERICA ID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com