1538588645 NPI number — PRATT - LOVERCHECK PRACTICE

Table of content: DR. ERIC F. REICHMAN PH.D., M.D. (NPI 1659371474)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1538588645 NPI number — PRATT - LOVERCHECK PRACTICE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PRATT - LOVERCHECK PRACTICE
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:
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:
1538588645
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/16/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1086 B US HWY 85
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAGRANGE
Provider Business Mailing Address State Name:
WY
Provider Business Mailing Address Postal Code:
82221
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
307-534-5582
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
231 CAMINO DEL REY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TORRINGTON
Provider Business Practice Location Address State Name:
WY
Provider Business Practice Location Address Postal Code:
82240
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
307-534-5582
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/16/2014

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LOVERCHECK
Authorized Official First Name:
BRENDA
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
307-534-5582

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LCSW-514 , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: WY 386 , registered in the state of WY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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