1538263892 NPI number — PETER A HURTUBISE

Table of content: MS. NANCY JEAN BYRNES APRN-BC (NPI 1487622783)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538263892 NPI number — PETER A HURTUBISE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PETER A HURTUBISE
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1538263892
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/19/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1887 LITITZ PIKE
Provider Second Line Business Mailing Address:
SUITE 6
Provider Business Mailing Address City Name:
LANCASTER
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17601
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-627-3133
Provider Business Mailing Address Fax Number:
717-569-3092

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1887 LITITZ PIKE
Provider Second Line Business Practice Location Address:
SUITE 6
Provider Business Practice Location Address City Name:
LANCASTER
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17601
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-627-3133
Provider Business Practice Location Address Fax Number:
717-569-3092
Provider Enumeration Date:
09/08/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HURTUBISE
Authorized Official First Name:
PETER
Authorized Official Middle Name:
A
Authorized Official Title or Position:
MEDICAL DIRECTOR OWNER
Authorized Official Telephone Number:
717-627-3133

Provider Taxonomy Codes

  • Taxonomy code: 261QM1300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0016661620003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




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