1477244267 NPI number — TRIUMPH THERAPEUTIC & CONSULTING GROUP

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1477244267 NPI number — TRIUMPH THERAPEUTIC & CONSULTING GROUP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRIUMPH THERAPEUTIC & CONSULTING GROUP
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:
STACY TRIUMPH
Provider Other Organization Name Type Code:
3
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:
1477244267
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/02/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
45 E CITY AVE # 1954
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BALA CYNWYD
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19004-2421
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
267-931-8824
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
19 GEORGETOWN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBUS
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
267-931-8824
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/15/2023

Additional Information

Authorized Official

Authorized Official Last Name:
TRIUMPH
Authorized Official First Name:
STACY
Authorized Official Middle Name:
ALLISON
Authorized Official Title or Position:
MANAGING MEMBER
Authorized Official Telephone Number:
267-931-8824

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0904016003 . This is a "LICENSED CLINICAL SOCIAL WORKER" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: Q1-0012060 . This is a "LICENSED CLINICAL SOCIAL WORKER" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 14785 . This is a "LICENSED CLINICAL SOCIAL WORKER" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: CW019266 . This is a "LICENSED CLINICAL SOCIAL WORKER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 44SC05722600 . This is a "LICENSED CLINICAL SOCIAL WORKER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: LC200002949 . This is a "LICENSED CLINICAL SOCIAL WORKER" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".




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