1497421945 NPI number — MS. ARIEL TAMARA PARKER LSW

Table of content: MS. ARIEL TAMARA PARKER LSW (NPI 1497421945)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497421945 NPI number — MS. ARIEL TAMARA PARKER LSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARKER
Provider First Name:
ARIEL
Provider Middle Name:
TAMARA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OXENDINE
Provider Other First Name:
ARIEL
Provider Other Middle Name:
TAMARA
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1497421945
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/16/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
217 S 16TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ALLENTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18102-4517
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
484-426-7571
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1115 LINDEN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BETHLEHEM
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18018-2903
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
484-273-2952
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/16/2021

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: 104100000X , with the licence number:  SW135153 , 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)