1831251180 NPI number — HYPERTENSION NEPHROLOGY ASSOCIATES, PC

Table of content: (NPI 1831251180)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831251180 NPI number — HYPERTENSION NEPHROLOGY ASSOCIATES, PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HYPERTENSION NEPHROLOGY ASSOCIATES, PC
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:
HYPERTENSION NEPHROLOGY ASSOCIATES, PC
Provider Other Organization Name Type Code:
3
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:
1831251180
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/23/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
735 FITZWATERTOWN RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WILLOW GROVE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19090-1332
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-657-2012
Provider Business Mailing Address Fax Number:
215-657-2018

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
735 FITZWATERTOWN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WILLOW GROVE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19090-1338
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-657-2019
Provider Business Practice Location Address Fax Number:
215-657-2018
Provider Enumeration Date:
12/14/2006

Additional Information

Authorized Official

Authorized Official Last Name:
PARKANSKY
Authorized Official First Name:
INESSA
Authorized Official Middle Name:
Authorized Official Title or Position:
MD
Authorized Official Telephone Number:
215-657-2012

Provider Taxonomy Codes

  • Taxonomy code: 207RN0300X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0048673000 . This is a "IBC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 096083 . This is a "HIGHMARK BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0008529130003 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 46456 . This is a "KEYSTONE MERCY PROVIDER #" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 04676 . This is a "AETNA PROVIDER NUMBER" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: CE0849 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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