1467493148 NPI number — THOMAS R NAMEY PT

Table of content: THOMAS R NAMEY PT (NPI 1467493148)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467493148 NPI number — THOMAS R NAMEY PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NAMEY
Provider First Name:
THOMAS
Provider Middle Name:
R
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT
Provider Gender Code:
M

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:
1467493148
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1187 FREEDOM RD
Provider Second Line Business Mailing Address:
STE C101
Provider Business Mailing Address City Name:
CRANBERRY TOWNSHIP
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16066
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-590-0494
Provider Business Mailing Address Fax Number:
724-590-0553

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1187 FREEDOM RD
Provider Second Line Business Practice Location Address:
STE C101
Provider Business Practice Location Address City Name:
CRANBERRY TOWNSHIP
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16066
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-590-0494
Provider Business Practice Location Address Fax Number:
724-590-0553
Provider Enumeration Date:
06/10/2006

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: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1599NA . This is a "REGENCE BLUE SHIELD" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 7818544 . This is a "AETNA" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: P00398751 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 1177NA . This is a "REGENCE BLUE SHIELD" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 8455339 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0210179 . This is a "DEPT. OF LABOR & INDUSTRY" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 8941712 . This is a "L&I CRIME VICTIMS" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".
  • Identifier: 1022NA . This is a "REGENCE BLUE SHIELD" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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