1619009990 NPI number — NORMA RECIO-PASIA MD

Table of content: NORMA RECIO-PASIA MD (NPI 1619009990)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619009990 NPI number — NORMA RECIO-PASIA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RECIO-PASIA
Provider First Name:
NORMA
Provider Middle Name:
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:
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:
1619009990
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O. BOX 822344
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:
19182-2344
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
314-991-0985
Provider Business Mailing Address Fax Number:
908-653-9305

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
28 NORTH 64TH STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BELLEVILLE
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
62223-3808
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
908-653-9399
Provider Business Practice Location Address Fax Number:
908-653-9305
Provider Enumeration Date:
03/12/2007

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: 207L00000X , with the licence number:  35071 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 35071 . This is a "MEDICAL LICENSE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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