1407845613 NPI number — DR. DANA L BILNOSKI D.O.

Table of content: DR. DANA L BILNOSKI D.O. (NPI 1407845613)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407845613 NPI number — DR. DANA L BILNOSKI D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BILNOSKI
Provider First Name:
DANA
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
NITKE
Provider Other First Name:
DANA
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.O.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1407845613
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/01/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
500 UNIVERSITY BLVD
Provider Second Line Business Mailing Address:
SUITE #208
Provider Business Mailing Address City Name:
JUPITER
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33458-2773
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-626-6695
Provider Business Mailing Address Fax Number:
561-626-6628

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
500 UNIVERSITY BLVD
Provider Second Line Business Practice Location Address:
SUITE #208
Provider Business Practice Location Address City Name:
JUPITER
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33458-2773
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-626-6695
Provider Business Practice Location Address Fax Number:
561-626-6628
Provider Enumeration Date:
10/19/2005

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: 207Q00000X , with the licence number:  3402 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207Q00000X , with the licence number: OS 8654 , registered in the state of FL ; 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