1780984112 NPI number — DEBORAH J CONTESTABILE

Table of content: (NPI 1780984112)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780984112 NPI number — DEBORAH J CONTESTABILE

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DEBORAH J CONTESTABILE
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:
1780984112
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/04/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5560 WILLIAM FLYNN HWY
Provider Second Line Business Mailing Address:
SUITE 104
Provider Business Mailing Address City Name:
GIBSONIA
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15044-9353
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-415-1429
Provider Business Mailing Address Fax Number:
724-234-4815

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5560 WILLIAM FLYNN HWY
Provider Second Line Business Practice Location Address:
SUITE 104
Provider Business Practice Location Address City Name:
GIBSONIA
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15044-9353
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-415-1429
Provider Business Practice Location Address Fax Number:
724-234-4815
Provider Enumeration Date:
11/02/2010

Additional Information

Authorized Official

Authorized Official Last Name:
CONTESTABILE
Authorized Official First Name:
DEBORAH
Authorized Official Middle Name:
J
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
724-415-1429

Provider Taxonomy Codes

  • Taxonomy code: 332B00000X , with the licence number:  6000007047 , 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: 1023070280001 . This is a "PA MEDICAID" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 2113050 . This is a "HIGHMARK" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com