1659367795 NPI number — DR. ROSANA HANKE HERRERO DMD

Table of content: DR. ROSANA HANKE HERRERO DMD (NPI 1659367795)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1659367795 NPI number — DR. ROSANA HANKE HERRERO DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HANKE HERRERO
Provider First Name:
ROSANA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
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:
1659367795
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/10/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
100 AVE LA SIERRA
Provider Second Line Business Mailing Address:
APT 9A
Provider Business Mailing Address City Name:
SAN JUAN
Provider Business Mailing Address State Name:
PR
Provider Business Mailing Address Postal Code:
00926-4316
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
787-293-5067
Provider Business Mailing Address Fax Number:
787-293-5067

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
576 TNT CESAR GONZALES AVE.
Provider Second Line Business Practice Location Address:
SUITE 307
Provider Business Practice Location Address City Name:
HATO REY
Provider Business Practice Location Address State Name:
PR
Provider Business Practice Location Address Postal Code:
00918
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
787-753-1475
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/23/2005

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: 1223P0221X , with the licence number:  2472 , registered in the state of PR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 26168 . This is a "AMERICAN HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 7899 . This is a "INTERNATIONAL MEDICAL IMC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 40291 HA . This is a "SEGUROS DE SERVICIOS SSS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9180469 . This is a "HUMANA REFORMA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 9180469 . This is a "HUMANA INSURANCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 043097 . This is a "LA CRUZ AZUL DE PR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 237026 . This is a "PREFERRED HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1595628 . This is a "UNITED CONCORDIA" identifier . This identifiers is of the category "OTHER".




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