1730830498 NPI number — DR. AARON RAY DALLMAN PHD, OTR/L

Table of content: DR. AARON RAY DALLMAN PHD, OTR/L (NPI 1730830498)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730830498 NPI number — DR. AARON RAY DALLMAN PHD, OTR/L

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DALLMAN
Provider First Name:
AARON
Provider Middle Name:
RAY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD, OTR/L
Provider Gender Code:
M

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:
1730830498
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/28/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3 BAIRD DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DENVILLE
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07834-1403
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
254-371-6350
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8892 STONEBROOK LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
COLUMBIA
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21046-1468
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-371-6350
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
01/14/2022

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: 225XP0200X , with the licence number:  09005 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 225XP0200X , with the licence number: 46TR01081800 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





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