1740211432 NPI number — DR. SHARON MARIE GWINN PHD, OTR/L, ABDA

Table of content: DR. SHARON MARIE GWINN PHD, OTR/L, ABDA (NPI 1740211432)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740211432 NPI number — DR. SHARON MARIE GWINN PHD, OTR/L, ABDA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GWINN
Provider First Name:
SHARON
Provider Middle Name:
MARIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PHD, OTR/L, ABDA
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:
1740211432
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/14/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
941 MELLON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PITTSBURGH
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15206-2129
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-304-0030
Provider Business Mailing Address Fax Number:
724-304-0035

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2501 LEECHBURG RD
Provider Second Line Business Practice Location Address:
SUITE A
Provider Business Practice Location Address City Name:
LOWER BURRELL
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15068-3060
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-304-0030
Provider Business Practice Location Address Fax Number:
724-304-0035
Provider Enumeration Date:
07/05/2006

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: 225X00000X , with the licence number:  OC003428L , 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: 2195109 . This is a "FIRST HEALTH PROVIDER NUM" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 3446732 . This is a "AETNA HMO PROVIDER NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 01946729 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5121792 . This is a "AETNA PPO PROVIDER NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1585451 . This is a "HIGHMARK BC/BS PROVIDER N" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 237320 . This is a "HEALTH AMERICA PROVIDER N" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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