1457443806 NPI number — DR. FRANCESCA FELICE AVELLINA OD

Table of content: DR. FRANCESCA FELICE AVELLINA OD (NPI 1457443806)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457443806 NPI number — DR. FRANCESCA FELICE AVELLINA OD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
AVELLINA
Provider First Name:
FRANCESCA
Provider Middle Name:
FELICE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
OD
Provider Gender Code:
F

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:
1457443806
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/17/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
07/17/2007
NPI Reactivation Date:
02/25/2008

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 BOONE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BREMERTON
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98312-1894
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-476-1714
Provider Business Mailing Address Fax Number:
360-476-2480

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1400 FARRAGUT AVE BLDG 940
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BREMERTON
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98314-6001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-476-1714
Provider Business Practice Location Address Fax Number:
360-476-2480
Provider Enumeration Date:
09/29/2006

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: 152W00000X , with the licence number:  7915T , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 2794 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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