1457308314 NPI number — KIDNEY AND HYPERTENSION ASSOCIATES P C

Table of content: (NPI 1457308314)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457308314 NPI number — KIDNEY AND HYPERTENSION ASSOCIATES P C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KIDNEY AND HYPERTENSION ASSOCIATES P C
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:
1457308314
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/25/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 538
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LEVITTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19058-0538
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-741-3510
Provider Business Mailing Address Fax Number:
215-741-3519

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
825 TOWN CENTER DR
Provider Second Line Business Practice Location Address:
SUITE 152
Provider Business Practice Location Address City Name:
LANGHORNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19047-1753
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-741-3510
Provider Business Practice Location Address Fax Number:
215-741-3519
Provider Enumeration Date:
05/27/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BRESSLER
Authorized Official First Name:
LAWRENCE
Authorized Official Middle Name:
PAUL
Authorized Official Title or Position:
TREASURER
Authorized Official Telephone Number:
215-741-3510

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1770748469 . This is a "NPI" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0015387990005 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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