1588722243 NPI number — FRIENDS RESEARCH INSTITUTE, INC.

Table of content: (NPI 1588722243)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1588722243 NPI number — FRIENDS RESEARCH INSTITUTE, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
FRIENDS RESEARCH INSTITUTE, INC.
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:
6
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:
1588722243
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/17/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1040 PARK AVE
Provider Second Line Business Mailing Address:
SUITE 103
Provider Business Mailing Address City Name:
BALTIMORE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21201-5633
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-837-3977
Provider Business Mailing Address Fax Number:
410-752-4218

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1107 N POINT BLVD
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
BALTIMORE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21224-3420
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-284-3070
Provider Business Practice Location Address Fax Number:
410-285-3848
Provider Enumeration Date:
12/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
TANGIRES
Authorized Official First Name:
SUSAN
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
410-744-4661

Provider Taxonomy Codes

  • Taxonomy code: 101YA0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 114351 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 56435 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".




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