1548275035 NPI number — JURTA LAPINSKI ASSOCIATES PC

Table of content: (NPI 1548275035)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548275035 NPI number — JURTA LAPINSKI ASSOCIATES PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JURTA LAPINSKI ASSOCIATES PC
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:
1548275035
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/05/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
33 EAST GREEN ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NANTICOKE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18634-2414
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-735-8002
Provider Business Mailing Address Fax Number:
570-735-8036

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
33 EAST GREEN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NANTICOKE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18634-2414
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-735-8002
Provider Business Practice Location Address Fax Number:
570-735-8036
Provider Enumeration Date:
07/31/2006

Additional Information

Authorized Official

Authorized Official Last Name:
JURTA
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
P
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
570-735-8002

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  SC002862L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 213E00000X , with the licence number: SC002870L , 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: 101215226001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: PDWE8 . This is a "EMPIRE BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 335279 . This is a "HEALTH ASSURANCE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: Q73380 . This is a "AMERIHEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 080539 . This is a "1ST PRIORITY HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1673380 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 4689 . This is a "GEISINGER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1079047 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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