1518082676 NPI number — DR. EMMA LUCIA YEPEZ-ZIEGENBALG D.C.

Table of content: DR. EMMA LUCIA YEPEZ-ZIEGENBALG D.C. (NPI 1518082676)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1518082676 NPI number — DR. EMMA LUCIA YEPEZ-ZIEGENBALG D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
YEPEZ-ZIEGENBALG
Provider First Name:
EMMA
Provider Middle Name:
LUCIA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
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:
1518082676
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/22/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
35 JEFFERY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
COLONIA
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07067-2413
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-499-9191
Provider Business Mailing Address Fax Number:
732-499-8618

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
622 INMAN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLONIA
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07067-1000
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-499-9191
Provider Business Practice Location Address Fax Number:
732-499-8618
Provider Enumeration Date:
03/20/2007

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: 111N00000X , with the licence number:  MC04763 , 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: 5138468 . This is a "AETNA PPO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: P2561573 . This is a "OXFORD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2087552 . This is a "AETNA HMO" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 2029096 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 31188 . This is a "MASTER CARE BEECH STREET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 5716539 . This is a "GHI" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: U75450 . This is a "HEALTHNET" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 66895 . This is a "OPERATING ENGINEERS LOCAL" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: IK9553 . This is a "LANDMARK" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 350051564 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: X4D801 . This is a "WELLCHOICE" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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