1720058696 NPI number — SARA ELIZABETH FRENCH

Table of content: SARA ELIZABETH FRENCH (NPI 1720058696)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720058696 NPI number — SARA ELIZABETH FRENCH

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FRENCH
Provider First Name:
SARA
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
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:
1720058696
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/13/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
208 E BAYFRONT PKWY SUITE 200C
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ERIE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16507-2413
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
814-871-6333
Provider Business Mailing Address Fax Number:
814-871-6335

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
208 E BAYFRONT PKWY SUITE 200C
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ERIE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16507-2413
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
814-871-6333
Provider Business Practice Location Address Fax Number:
814-871-6335
Provider Enumeration Date:
01/24/2006

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: 101YP2500X , with the licence number:  PC003467 , 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: 1628150 . This is a "HIGHMARK KHPW" identifier . This identifiers is of the category "OTHER".
  • Identifier: 62303 . This is a "CIGNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 515237 . This is a "VALUE OPTIONS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2254929 . This is a "COMP PSYCH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 00000 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 786984-000 . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 22771 . This is a "MANAGED HEALTH NETWORK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 706365 . This is a "UPMC COMMERCIAL" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 38520 . This is a "TRICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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