1669786711 NPI number — SAMANTHA MARIE T ALMENDRAS MD

Table of content: SAMANTHA MARIE T ALMENDRAS MD (NPI 1669786711)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669786711 NPI number — SAMANTHA MARIE T ALMENDRAS MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALMENDRAS
Provider First Name:
SAMANTHA MARIE
Provider Middle Name:
T
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1669786711
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/18/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3600 W MARKET ST
Provider Second Line Business Mailing Address:
#200
Provider Business Mailing Address City Name:
FAIRLAWN
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
44333-4540
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
330-666-2700
Provider Business Mailing Address Fax Number:
330-666-0500

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3600 W MARKET ST
Provider Second Line Business Practice Location Address:
#200
Provider Business Practice Location Address City Name:
FAIRLAWN
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
44333-4540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
330-666-2700
Provider Business Practice Location Address Fax Number:
330-666-0500
Provider Enumeration Date:
07/31/2010

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: 207R00000X , with the licence number:  35-120940 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0083407 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2551671 . This is a "PARTNERS PHYSICIAN GROUP MEDICAID GROUP #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1841239274 . This is a "PARTNERS PHYSICIAN GROUP TYPE 2 NPI #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 9338635 . This is a "PARTNERS PHYSICIAN GROUP MEDICARE GROUP #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com