1558700872 NPI number — MAGGIE ANN SEEL OTR/L

Table of content: MAGGIE ANN SEEL OTR/L (NPI 1558700872)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558700872 NPI number — MAGGIE ANN SEEL OTR/L

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEEL
Provider First Name:
MAGGIE
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
OTR/L
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WOLENTER
Provider Other First Name:
MAGGIE
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
OTR/L
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1558700872
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/17/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
220 S LECATO AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
AUDUBON
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08106-1134
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
609-504-5704
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1020 PITNEY RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ABSECON
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08201-9716
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
609-646-5400
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/19/2013

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: 225X00000X , with the licence number:  OT.0003587 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X , with the licence number: OC012476 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X , with the licence number: 46TR00816600 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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