1538185582 NPI number — BARBARA B HACKMAN MD

Table of content: BARBARA B HACKMAN MD (NPI 1538185582)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538185582 NPI number — BARBARA B HACKMAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HACKMAN
Provider First Name:
BARBARA
Provider Middle Name:
B
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1538185582
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/01/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8 FORREST LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STRAFFORD
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19087-2504
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-651-7760
Provider Business Mailing Address Fax Number:
610-644-7517

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
209 W LANCASTER AVE
Provider Second Line Business Practice Location Address:
SUITE #101
Provider Business Practice Location Address City Name:
PAOLI
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19301-1749
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-651-7760
Provider Business Practice Location Address Fax Number:
610-644-7517
Provider Enumeration Date:
07/14/2006

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: 207QA0505X , with the licence number:  MD072634L , 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: 001300519 . This is a "HIGHMARK BS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0894882000 . This is a "INDEPENDENCE BC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0007349249 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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