1407079270 NPI number — MRS. CAROL CRUMRINE BREWER M.S., OTRL

Table of content: MRS. CAROL CRUMRINE BREWER M.S., OTRL (NPI 1407079270)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407079270 NPI number — MRS. CAROL CRUMRINE BREWER M.S., OTRL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BREWER
Provider First Name:
CAROL
Provider Middle Name:
CRUMRINE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.S., OTRL
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CRUMRINE
Provider Other First Name:
CAROL
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
OTRL
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1407079270
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
48 CRYSTAL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAKMONT
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15139-1015
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-826-8373
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1301 CARLISLE ST
Provider Second Line Business Practice Location Address:
OT DEPARTMENT
Provider Business Practice Location Address City Name:
NATRONA HEIGHTS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15065-1152
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-226-7278
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/10/2007

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: 225X00000X , with the licence number:  OC000054L , 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)





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