1609014943 NPI number — MS. NATALIE BLEDSTEIN OTR, CST

Table of content: MS. NATALIE BLEDSTEIN OTR, CST (NPI 1609014943)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609014943 NPI number — MS. NATALIE BLEDSTEIN OTR, CST

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BLEDSTEIN
Provider First Name:
NATALIE
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
OTR, CST
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:
1609014943
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/09/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
543 A J ALLEN CIR
Provider Second Line Business Mailing Address:
STE A1, BOX 8
Provider Business Mailing Address City Name:
WALES
Provider Business Mailing Address State Name:
WI
Provider Business Mailing Address Postal Code:
53183-9542
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
262-968-2001
Provider Business Mailing Address Fax Number:
262-347-3371

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
543 A J ALLEN CIR
Provider Second Line Business Practice Location Address:
STE A1, BOX 8
Provider Business Practice Location Address City Name:
WALES
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53183-9542
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
262-968-2001
Provider Business Practice Location Address Fax Number:
262-347-3371
Provider Enumeration Date:
01/24/2009

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: 225X00000X , with the licence number:  2307-26 , registered in the state of WI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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