1881900587 NPI number — TIOGA HEALTH CARE PROVIDERS 12

Table of content: BRIAN KEITH STEINER LMFT (NPI 1043390008)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881900587 NPI number — TIOGA HEALTH CARE PROVIDERS 12

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TIOGA HEALTH CARE PROVIDERS 12
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:
1881900587
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
02/28/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15 MEADE ST
Provider Second Line Business Mailing Address:
SUITE U3
Provider Business Mailing Address City Name:
WELLSBORO
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
16901-1813
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
570-724-3636
Provider Business Mailing Address Fax Number:
570-724-3326

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
15 MEADE ST
Provider Second Line Business Practice Location Address:
SUITE U3
Provider Business Practice Location Address City Name:
WELLSBORO
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
16901-1813
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
570-724-3636
Provider Business Practice Location Address Fax Number:
570-724-3326
Provider Enumeration Date:
08/19/2010

Additional Information

Authorized Official

Authorized Official Last Name:
BELLINGER
Authorized Official First Name:
EDWARD
Authorized Official Middle Name:
L
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
570-724-3636

Provider Taxonomy Codes

  • Taxonomy code: 208800000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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