1619298825 NPI number — APRIL RAE LIEB PA

Table of content: APRIL RAE LIEB PA (NPI 1619298825)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619298825 NPI number — APRIL RAE LIEB PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LIEB
Provider First Name:
APRIL
Provider Middle Name:
RAE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
COX
Provider Other First Name:
APRIL
Provider Other Middle Name:
R
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1619298825
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/22/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1800 N BLANCHARD ST
Provider Second Line Business Mailing Address:
SUITE 121
Provider Business Mailing Address City Name:
FINDLAY
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45840-4503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-427-0809
Provider Business Mailing Address Fax Number:
419-427-2840

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 N BLANCHARD ST
Provider Second Line Business Practice Location Address:
SUITE 121
Provider Business Practice Location Address City Name:
FINDLAY
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45840-4503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-427-0809
Provider Business Practice Location Address Fax Number:
419-427-2840
Provider Enumeration Date:
06/22/2010

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: 363A00000X , with the licence number:  50003080 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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