1598808719 NPI number — DR ALAN D. CORNFIELD SILVER SPRING CHIROPRACTIC PA

Table of content: (NPI 1598808719)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1598808719 NPI number — DR ALAN D. CORNFIELD SILVER SPRING CHIROPRACTIC PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR ALAN D. CORNFIELD SILVER SPRING CHIROPRACTIC PA
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:
1598808719
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/03/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2730 UNIVERSITY BLVD W STE 500
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHEATON
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20902-1975
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-585-2225
Provider Business Mailing Address Fax Number:
301-929-0245

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2730 UNIVERSITY BLVD W STE 500
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHEATON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20902-1975
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-585-2225
Provider Business Practice Location Address Fax Number:
301-929-0245
Provider Enumeration Date:
02/15/2007

Additional Information

Authorized Official

Authorized Official Last Name:
CORNFIELD
Authorized Official First Name:
ALAN
Authorized Official Middle Name:
D.
Authorized Official Title or Position:
C.E.O.
Authorized Official Telephone Number:
301-585-2225

Provider Taxonomy Codes

  • Taxonomy code: 111NN0400X , with the licence number:  S01370 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111NX0800X , with the licence number: S01370 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 111NX0800X , with the licence number: D0046195 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 22351 . This is a "GW HEALTH PLAN" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 32824 . This is a "MAMSI HEALTH PLAN" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: COR001 . This is a "MANAGED CHIROPRACTIC CARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 222945900 . This is a "DEPT OF LABOR" identifier , issued by the state of ( DC ) . This identifiers is of the category "OTHER".
  • Identifier: 000380039001 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 4369843 . This is a "AETNA" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 200056 . This is a "ACN KAISER OF MIDATLANTIC" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".
  • Identifier: 40026801 . This is a "BC BS OF MD" identifier , issued by the state of ( MD ) . This identifiers is of the category "OTHER".




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