1669697249 NPI number — PERINATAL PARTNERS, LLC

Table of content: (NPI 1669697249)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669697249 NPI number — PERINATAL PARTNERS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PERINATAL PARTNERS, LLC
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:
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:
1669697249
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 WYOMING ST
Provider Second Line Business Mailing Address:
BERRY BLDG GROUND
Provider Business Mailing Address City Name:
DAYTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45409-2722
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-208-6088
Provider Business Mailing Address Fax Number:
937-208-5190

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7707 PARAGON RD
Provider Second Line Business Practice Location Address:
STE 103
Provider Business Practice Location Address City Name:
DAYTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45459-4041
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-208-6970
Provider Business Practice Location Address Fax Number:
937-208-6974
Provider Enumeration Date:
04/17/2007

Additional Information

Authorized Official

Authorized Official Last Name:
STUERMAN
Authorized Official First Name:
TERRY
Authorized Official Middle Name:
L
Authorized Official Title or Position:
VP, SECRETARY,TREASURER
Authorized Official Telephone Number:
937-208-6088

Provider Taxonomy Codes

  • Taxonomy code: 207VM0101X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1730184698 . This is a "NPI WYOMING ST. LOCATION" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1780689638 . This is a "NPI RAN NEIGER, MD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 2184532 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1023013976 . This is a "NPI JIRI SONEK, MD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1235134180 . This is a "NPI CHRISOPHER CROOM, MD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1578568424 . This is a "NPI DAVID MCKENNA, MD" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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