1487764486 NPI number — PETER O OSKANIAN MD

Table of content: PETER O OSKANIAN MD (NPI 1487764486)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1487764486 NPI number — PETER O OSKANIAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
OSKANIAN
Provider First Name:
PETER
Provider Middle Name:
O
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1487764486
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/10/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
211 S GULPH RD STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
KING OF PRUSSIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19406-3101
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-382-5916
Provider Business Mailing Address Fax Number:
484-381-8028

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 N SUNNYBROOK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
POTTSTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19464-2946
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-323-5550
Provider Business Practice Location Address Fax Number:
610-327-4651
Provider Enumeration Date:
08/30/2006

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: 208800000X , with the licence number:  MD063803L , 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: 6469300001 . This is a "MEDICARE DME" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 6469300002 . This is a "MEDICARE DME (2ND LOCATION)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0017687430003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com