1497907117 NPI number — MS. CECILIA W. DAVID ACNP

Table of content: MS. CECILIA W. DAVID ACNP (NPI 1497907117)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497907117 NPI number — MS. CECILIA W. DAVID ACNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DAVID
Provider First Name:
CECILIA
Provider Middle Name:
W.
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ACNP
Provider Gender Code:
F

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:
1497907117
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 FRANKLIN SQUARE DRIVE
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
SOMERSET
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08873-4109
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-429-7799
Provider Business Mailing Address Fax Number:
866-611-9616

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
100 FRANKLIN SQUARE DRIVE
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
SOMERSET
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08873-4109
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-429-7799
Provider Business Practice Location Address Fax Number:
866-611-9616
Provider Enumeration Date:
10/13/2008

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: 363L00000X , with the licence number:  26NR07545100 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 302960 . This is a "NEW YORK STATE LICENSE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 26NR07545100 . This is a "RPN LICENSE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 26NN07545100 . This is a "APN STATE LICENSE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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