1558447466 NPI number — STEPHANIE ALTER RN

Table of content: STEPHANIE ALTER RN (NPI 1558447466)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558447466 NPI number — STEPHANIE ALTER RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALTER
Provider First Name:
STEPHANIE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
ZAPPA
Provider Other First Name:
STEPHANIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1558447466
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/19/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7067 TIFFANY BLVD
Provider Second Line Business Mailing Address:
STE 230
Provider Business Mailing Address City Name:
YOUNGSTOWN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44514-1981
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-758-2748
Provider Business Mailing Address Fax Number:
330-758-3282

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
667 EASTLAND AVE SE
Provider Second Line Business Practice Location Address:
SUITE 301
Provider Business Practice Location Address City Name:
WARREN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44484-4503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-841-4046
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/31/2006

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: 363LA2200X , with the licence number:  RN.142133-COA1 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2368718 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com