1902091804 NPI number — MAKEFIELD CHIROPRACTIC CENTER P C

Table of content: (NPI 1902091804)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1902091804 NPI number — MAKEFIELD CHIROPRACTIC CENTER P C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MAKEFIELD CHIROPRACTIC CENTER P C
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:
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:
1902091804
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/26/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11 FRIENDS LN
Provider Second Line Business Mailing Address:
SUITE A159
Provider Business Mailing Address City Name:
NEWTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
18940-1885
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-860-9660
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
11 FRIENDS LN
Provider Second Line Business Practice Location Address:
SUITE A159
Provider Business Practice Location Address City Name:
NEWTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
18940-1885
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-860-9660
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
SANGIORGIO
Authorized Official First Name:
THOMAS
Authorized Official Middle Name:
M
Authorized Official Title or Position:
OWNER/CHIROPRACTOR
Authorized Official Telephone Number:
215-860-9660

Provider Taxonomy Codes

  • Taxonomy code: 111NS0005X , with the licence number:  DC-005434-L , 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