1619037264 NPI number — DR. RUTA U MAYEKAR MD

Table of content: DR. RUTA U MAYEKAR MD (NPI 1619037264)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619037264 NPI number — DR. RUTA U MAYEKAR MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MAYEKAR
Provider First Name:
RUTA
Provider Middle Name:
U
Provider Name Prefix Text:
DR.
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:
1619037264
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1750
Provider Second Line Business Mailing Address:
DELCO PSYCHIATRIC ASSOCIATES LLC
Provider Business Mailing Address City Name:
CHADDS FORD
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19317
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-461-3530
Provider Business Mailing Address Fax Number:
610-461-3532

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2173 MACDADE BLVD
Provider Second Line Business Practice Location Address:
SUITE K/L
Provider Business Practice Location Address City Name:
HOLMES
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19043-1217
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-461-3530
Provider Business Practice Location Address Fax Number:
610-461-3532
Provider Enumeration Date:
12/12/2006

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: 2084P0804X , with the licence number:  MD030644E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0010637200017 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 539935 . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 250897 . This is a "MENTAL HEALTH NETWORK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 250879 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2622998000 . This is a "PERSONAL CHOICE" identifier . This identifiers is of the category "OTHER".




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