1619306669 NPI number — KAREN A SAPORITO PH.D.

Table of content: KAREN A SAPORITO PH.D. (NPI 1619306669)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619306669 NPI number — KAREN A SAPORITO PH.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SAPORITO
Provider First Name:
KAREN
Provider Middle Name:
A
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PH.D.
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:
1619306669
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/18/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
719 CLARK DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MULLICA HILL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
08062-1839
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
856-278-6095
Provider Business Mailing Address Fax Number:
866-567-5687

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1420 WALNUT ST
Provider Second Line Business Practice Location Address:
SUITE 1206
Provider Business Practice Location Address City Name:
PHILADELPHIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19102-4017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-278-6095
Provider Business Practice Location Address Fax Number:
866-567-5687
Provider Enumeration Date:
11/09/2013

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: 103TC0700X , with the licence number:  PS-009168-L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103TC0700X , with the licence number: 35S100426200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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