1467461046 NPI number — EILEEN ANN MUESELER D.O.

Table of content: EILEEN ANN MUESELER D.O. (NPI 1467461046)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467461046 NPI number — EILEEN ANN MUESELER D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MUESELER
Provider First Name:
EILEEN
Provider Middle Name:
ANN
Provider Name Prefix Text:
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:
FLORIN
Provider Other First Name:
EILEEN
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.O.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1467461046
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/17/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
434 E PITTSBURGH ST
Provider Second Line Business Mailing Address:
SUITE 17
Provider Business Mailing Address City Name:
GREENSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15601-2644
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-837-3877
Provider Business Mailing Address Fax Number:
724-837-3307

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
434 E PITTSBURGH ST
Provider Second Line Business Practice Location Address:
SUITE 17
Provider Business Practice Location Address City Name:
GREENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15601-2644
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-837-3877
Provider Business Practice Location Address Fax Number:
724-837-3307
Provider Enumeration Date:
08/05/2006

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: 207Q00000X , with the licence number:  OS007324E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 102277395 0001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".