1609812353 NPI number — VALERIE PAPACONSTANTINOU BAUER MD

Table of content: VALERIE PAPACONSTANTINOU BAUER MD (NPI 1609812353)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609812353 NPI number — VALERIE PAPACONSTANTINOU BAUER MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAUER
Provider First Name:
VALERIE
Provider Middle Name:
PAPACONSTANTINOU
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PAPACONSTANTINOU
Provider Other First Name:
VALERIE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1609812353
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/15/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 824967
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PHILADELPHIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19182-4967
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-941-8933
Provider Business Mailing Address Fax Number:
732-918-8940

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2211 CHAPEL AVE W STE 301
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CHERRY HILL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08002-2062
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-665-2017
Provider Business Practice Location Address Fax Number:
856-488-6769
Provider Enumeration Date:
06/21/2006

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: 208C00000X , with the licence number:  25MA11338500 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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