1689957367 NPI number — MRS. HEATHER LYNN PARMELEE GRANIERI LPTA

Table of content: MRS. HEATHER LYNN PARMELEE GRANIERI LPTA (NPI 1689957367)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1689957367 NPI number — MRS. HEATHER LYNN PARMELEE GRANIERI LPTA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PARMELEE GRANIERI
Provider First Name:
HEATHER
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LPTA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GRANIERI
Provider Other First Name:
HEATHER
Provider Other Middle Name:
LYNN
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPTA
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1689957367
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/20/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
37 MARYLAND AVE
Provider Second Line Business Mailing Address:
UNIT 233
Provider Business Mailing Address City Name:
ROCKVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20850-2437
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-873-7284
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
37 MARYLAND AVE
Provider Second Line Business Practice Location Address:
#233
Provider Business Practice Location Address City Name:
ROCKVILLE
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20850
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-873-7284
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/20/2011

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: 225200000X , with the licence number:  A3683 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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