1568602407 NPI number — MRS. SABRINA L LETNER OTR/L, CHT

Table of content: MRS. SABRINA L LETNER OTR/L, CHT (NPI 1568602407)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1568602407 NPI number — MRS. SABRINA L LETNER OTR/L, CHT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LETNER
Provider First Name:
SABRINA
Provider Middle Name:
L
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
OTR/L, CHT
Provider Gender Code:
F

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:
1568602407
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/24/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
230 CLEARFIELD AVE STE 124
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VIRGINIA BEACH
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
23462-1832
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
757-321-3300
Provider Business Mailing Address Fax Number:
757-321-3332

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
501 DISCOVERY DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHESAPEAKE
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
23320-3843
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-368-3284
Provider Business Practice Location Address Fax Number:
757-368-3902
Provider Enumeration Date:
03/05/2009

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: 225XH1200X , with the licence number:  0119001261 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1568602407 . This is a "MEDICAID QMB ONLY" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 541869072 . This is a "TAX ID" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: C05954 . This is a "MEDICARE GROUP PTAN" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".




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