1396733218 NPI number — PAMELA GUERRIERE-KOVACH M.D.

Table of content: PAMELA GUERRIERE-KOVACH M.D. (NPI 1396733218)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396733218 NPI number — PAMELA GUERRIERE-KOVACH M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUERRIERE-KOVACH
Provider First Name:
PAMELA
Provider Middle Name:
Provider Name Prefix Text:
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:
1396733218
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5208 MAHONING AVE STE 208
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YOUNGSTOWN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44515-1859
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-799-9270
Provider Business Mailing Address Fax Number:
330-799-2295

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5208 MAHONING AVE STE 208
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
YOUNGSTOWN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44515-1859
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-799-9270
Provider Business Practice Location Address Fax Number:
330-799-2295
Provider Enumeration Date:
10/13/2005

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: 174400000X , with the licence number:  35074029G , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZD0900X , with the licence number: 20881 , registered in the state of WV ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZD0900X , with the licence number: 0101231016 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZD0900X , with the licence number: ME84498 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZD0900X , with the licence number: MD418830 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207ZD0900X , with the licence number: 35074029 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 7910405 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 300177497002 . This is a "MEDICAL MUTUAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000285461 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000282926 . This is a "ANTHEM BCBS" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 6703070000 , issued by the state of ( WV ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1101310 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2407818 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 341952521003 . This is a "MEDICAL MUTUAL" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 010128099 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 300177497 . This is a "UNITED" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com