1669697330 NPI number — ADAM J TEICHMAN DPM

Table of content: (NPI 1669697330)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669697330 NPI number — ADAM J TEICHMAN DPM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ADAM J TEICHMAN DPM
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:
1669697330
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6997 TUSCANY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MACUNGIE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18062-8971
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-432-9593
Provider Business Mailing Address Fax Number:
610-432-4887

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2895 HAMILTON BLVD
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
ALLENTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18104-6172
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-432-9593
Provider Business Practice Location Address Fax Number:
610-432-4887
Provider Enumeration Date:
04/16/2007

Additional Information

Authorized Official

Authorized Official Last Name:
TEICHMAN
Authorized Official First Name:
ADAM
Authorized Official Middle Name:
J
Authorized Official Title or Position:
DOCTOR
Authorized Official Telephone Number:
610-432-9593

Provider Taxonomy Codes

  • Taxonomy code: 213E00000X , with the licence number:  SC005850 , 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: P00388796 . This is a "RRB - MEDICARE RAILROAD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1294499 . This is a "CIGNA HEALTH CARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1557148 . This is a "GATEWAY HEALTH PLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1903786 . This is a "HIGHMARK BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 20049033 . This is a "AMERIHEALTH MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2773605000 . This is a "INDEPENDENCE BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 50064486 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 106115 . This is a "STERLING" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2773605000 . This is a "KEYSTONE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2773605000 . This is a "AMERIHEALTH ADMINISTRATORS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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