1447467568 NPI number — MRS. SHARON A SCHUSTER CST PA

Table of content: MRS. SHARON A SCHUSTER CST PA (NPI 1447467568)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447467568 NPI number — MRS. SHARON A SCHUSTER CST PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHUSTER
Provider First Name:
SHARON
Provider Middle Name:
A
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CST PA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SCHUSTER
Provider Other First Name:
SHERRY
Provider Other Middle Name:
A
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
CST PA
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1447467568
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:
230 AUDUBON DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANDEVILLE
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
70471
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
985-845-1501
Provider Business Mailing Address Fax Number:
985-845-1601

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
230 AUDUBON DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANDEVILLE
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
70471
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
985-845-1501
Provider Business Practice Location Address Fax Number:
985-845-1601
Provider Enumeration Date:
05/17/2007

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: 363AS0400X , with the licence number:  CN94527 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: CN94527 . This is a "NAT ASSOC OF CERT ASSISTI" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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