1831143544 NPI number — DEAN HUTCHINSON PT

Table of content: DEAN HUTCHINSON PT (NPI 1831143544)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831143544 NPI number — DEAN HUTCHINSON PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUTCHINSON
Provider First Name:
DEAN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT
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:
1831143544
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/30/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 W 10TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MARCUS HOOK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19061-4513
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-859-8850
Provider Business Mailing Address Fax Number:
610-859-7876

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
605 GLEN AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MOORESTOWN
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
08057-1125
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
856-335-5060
Provider Business Practice Location Address Fax Number:
856-793-9392
Provider Enumeration Date:
05/19/2006

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: 225100000X , with the licence number:  J1-0001740 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT011834L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: 40QA00789400 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0000000237564 . This is a "AMERICHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0792823000 . This is a "IBC" identifier . This identifiers is of the category "OTHER".
  • Identifier: P00692865 . This is a "MEDICARE RR" identifier . This identifiers is of the category "OTHER".
  • Identifier: 007603590-0002 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1831143544 . This is a "DPCI" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 30051352 . This is a "KEYSTONE MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 879642 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".




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