1598737090 NPI number — DR. DONALD EDMOND O'MALLEY M.D.

Table of content: RAHAT SAIED M.D. (NPI 1952497406)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598737090 NPI number — DR. DONALD EDMOND O'MALLEY M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
O'MALLEY
Provider First Name:
DONALD
Provider Middle Name:
EDMOND
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1598737090
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/29/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 765
Provider Second Line Business Mailing Address:
360 GIFFORD ST UNIT 2B
Provider Business Mailing Address City Name:
FALMOUTH
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02541-0765
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-540-0200
Provider Business Mailing Address Fax Number:
508-540-1677

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
360 GIFFORD ST
Provider Second Line Business Practice Location Address:
UNIT 2B
Provider Business Practice Location Address City Name:
FALMOUTH
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02540-2912
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-540-0200
Provider Business Practice Location Address Fax Number:
508-540-1677
Provider Enumeration Date:
02/07/2006

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: 174400000X , with the licence number:  157476 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 8429172001 . This is a "CIGNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 202895805 . This is a "AETNA" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 240681 . This is a "HARVARD PILGRIM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 157476 . This is a "TUFTS" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: 202895805 . This is a "HEALTH CARE VALUE MANAGEM" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".
  • Identifier: J18951 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( MA ) . This identifiers is of the category "OTHER".




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