1538215322 NPI number — DR. PATRICIA GAIL MARLAR DC

Table of content: LAURA R TRIERWEILER OT (NPI 1083850218)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538215322 NPI number — DR. PATRICIA GAIL MARLAR DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MARLAR
Provider First Name:
PATRICIA
Provider Middle Name:
GAIL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
EISEL
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
GAIL
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1538215322
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/31/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1031 SANDA DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15227-3925
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-779-0626
Provider Business Mailing Address Fax Number:
412-341-2613

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4146 LIBRARY RD
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
PITTSBURGH
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15234-1350
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-343-6310
Provider Business Practice Location Address Fax Number:
412-341-2613
Provider Enumeration Date:
01/26/2007

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:  DC007980L , 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: 815732 . This is a "HM BCBS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 5665707001 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: DC-007980-L . This is a "STATE LICENSE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1851615157 . This is a "GROUP NATIONAL ID" identifier . This identifiers is of the category "OTHER".




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