1407253859 NPI number — DR NATALIE TEYGART PC

Table of content: (NPI 1407253859)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407253859 NPI number — DR NATALIE TEYGART PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR NATALIE TEYGART PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1407253859
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/24/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
939 WEST 38TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ERIE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16508
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-456-8105
Provider Business Mailing Address Fax Number:
814-456-8126

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
939 WEST 38TH ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ERIE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16508
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-456-8105
Provider Business Practice Location Address Fax Number:
814-456-8126
Provider Enumeration Date:
12/01/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
TEYGART
Authorized Official First Name:
NATALIE
Authorized Official Middle Name:
Authorized Official Title or Position:
MANAGER
Authorized Official Telephone Number:
814-528-1695

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  OS014970 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207QA0505X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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