1922137736 NPI number — MRS. REBEKAH GOLDSTEIN GIANNAKOS CRNP

Table of content: MRS. REBEKAH GOLDSTEIN GIANNAKOS CRNP (NPI 1922137736)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922137736 NPI number — MRS. REBEKAH GOLDSTEIN GIANNAKOS CRNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GIANNAKOS
Provider First Name:
REBEKAH
Provider Middle Name:
GOLDSTEIN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNP
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:
1922137736
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
UNIVERSITY OF MARYLAND UNIVERSITY HEALTH CTR
Provider Second Line Business Mailing Address:
CAMPUS DRIVE, BUILDING 140, ROOM 0106
Provider Business Mailing Address City Name:
COLLEGE PARK
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20742-0001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-314-8172
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
UNIVERSITY OF MARYLAND UNIVERSITY HEALTH CTR
Provider Second Line Business Practice Location Address:
CAMPUS DRIVE, BUILDING 140, ROOM 0106
Provider Business Practice Location Address City Name:
COLLEGE PARK
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20742-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-314-8172
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/05/2007

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: 363LA2200X , with the licence number:  R125869 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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