1861878662 NPI number — FELICIA PORRAZZA MDA, RDN, LDN, CPT

Table of content: FELICIA PORRAZZA MDA, RDN, LDN, CPT (NPI 1861878662)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861878662 NPI number — FELICIA PORRAZZA MDA, RDN, LDN, CPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PORRAZZA
Provider First Name:
FELICIA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MDA, RDN, LDN, CPT
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:
1861878662
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/18/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1331 EAST LINCOLN HIGHWAY
Provider Second Line Business Mailing Address:
#216
Provider Business Mailing Address City Name:
LEVITTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19056-2213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-821-7045
Provider Business Mailing Address Fax Number:
610-200-5782

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
601 WARWICK RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRLESS HILLS
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19030
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-821-7045
Provider Business Practice Location Address Fax Number:
610-200-5782
Provider Enumeration Date:
08/04/2015

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: 133V00000X , with the licence number:  DN005379 , 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)





Copyright © 2007-2025 www.npivalidator.com