1699884296 NPI number — ROSANNE TERRANOVA SEILER NP

Table of content: SANTINO TAFARELLA (NPI 1841667482)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699884296 NPI number — ROSANNE TERRANOVA SEILER NP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SEILER
Provider First Name:
ROSANNE
Provider Middle Name:
TERRANOVA
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NP
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:
1699884296
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8814 PEER RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH LYON
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48178
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
248-486-3874
Provider Business Mailing Address Fax Number:
248-669-0136

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
29270 MORLOCK STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LIVONIA
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48152
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-476-0555
Provider Business Practice Location Address Fax Number:
248-477-5391
Provider Enumeration Date:
08/29/2006

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: 363L00000X , with the licence number:  4704145939 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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