1710943345 NPI number — DR. HILDY L STRONGWATER OD

Table of content: DR. HILDY L STRONGWATER OD (NPI 1710943345)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710943345 NPI number — DR. HILDY L STRONGWATER OD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STRONGWATER
Provider First Name:
HILDY
Provider Middle Name:
L
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
OD
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:
1710943345
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/25/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
441 NORTHAMPTON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EASTEN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18042
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-253-8132
Provider Business Mailing Address Fax Number:
610-252-2286

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2414 MACARTHUR RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITEHALL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18052-3810
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-432-3937
Provider Business Practice Location Address Fax Number:
610-432-0124
Provider Enumeration Date:
04/22/2006

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: 152W00000X , with the licence number:  OE006824T , 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: 02541400 . This is a "CAPITAL BLUE CROSS GROUP" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0011401130004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01554301 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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