1629079124 NPI number — LOUIS S MARKOWITZ O D & ASSOCIATES INC.

Table of content: (NPI 1629079124)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629079124 NPI number — LOUIS S MARKOWITZ O D & ASSOCIATES INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LOUIS S MARKOWITZ O D & ASSOCIATES INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
6
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:
1629079124
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
101 HERITAGE RUN
Provider Second Line Business Mailing Address:
SUITE 2
Provider Business Mailing Address City Name:
INDIANA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15701-1584
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-349-4985
Provider Business Mailing Address Fax Number:
724-463-9765

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
101 HERITAGE RUN RD
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
INDIANA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15701-1584
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-349-4985
Provider Business Practice Location Address Fax Number:
724-463-9765
Provider Enumeration Date:
08/09/2005

Additional Information

Authorized Official

Authorized Official Last Name:
ZBIGNEWICH
Authorized Official First Name:
FRANK
Authorized Official Middle Name:
E
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
724-349-4985

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , 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: 0009360760004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: CG0080 . This is a "RRMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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