1710911912 NPI number — WILLIAM H. LENZ, DPM, PC

Table of content: (NPI 1710911912)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710911912 NPI number — WILLIAM H. LENZ, DPM, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
WILLIAM H. LENZ, DPM, PC
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:
6
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:
1710911912
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/20/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
495 WATERFRONT DR E
Provider Second Line Business Mailing Address:
SUITE 230
Provider Business Mailing Address City Name:
HOMESTEAD
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15120-1140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
412-461-1108
Provider Business Mailing Address Fax Number:
412-461-5490

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
495 WATERFRONT DR E
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
HOMESTEAD
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15120-1140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
412-461-1108
Provider Business Practice Location Address Fax Number:
412-461-5490
Provider Enumeration Date:
07/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LYNCH
Authorized Official First Name:
DIANE
Authorized Official Middle Name:
L
Authorized Official Title or Position:
OPERATIONS MANAGER
Authorized Official Telephone Number:
412-461-1108

Provider Taxonomy Codes

  • Taxonomy code: 213ES0103X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1366414088 . This is a "INDIVIDUAL NPI JOHN DISTAZIO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1972582476 . This is a "INDIVIDUAL NPI KATHLEEN O'CONNELL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: T30166 . This is a "UPIN WILLIAM LENZ" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1861464836 . This is a "INDIVIDUAL NPI STEPHEN KRULJAC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1760454326 . This is a "INDIVIDUAL NPI WILLIAM LENZ" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 455619 . This is a "BLUE SHIELD PROVIDER NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: T28597 . This is a "UPIN STEPHEN KRULJAC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: T29930 . This is a "UPIN JOHN DISTAZIO" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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