1922327147 NPI number — MONTGOMERY COUNTY COURTHOUSE DBA PUBLIC HEALTH - DAYTON & MONTGOMERY C

Table of content: CORNELIA HELENE PASQUINI CRNP (NPI 1932160579)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922327147 NPI number — MONTGOMERY COUNTY COURTHOUSE DBA PUBLIC HEALTH - DAYTON & MONTGOMERY C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MONTGOMERY COUNTY COURTHOUSE DBA PUBLIC HEALTH - DAYTON & MONTGOMERY 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:
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:
1922327147
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/27/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
117 SOUTH MAIN ST.
Provider Second Line Business Mailing Address:
ROOM 209, ATTN: DEBORAH PETERSON
Provider Business Mailing Address City Name:
DAYTON
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45422-1280
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-496-3344
Provider Business Mailing Address Fax Number:
937-496-3071

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1323 W 3RD ST RM 509
Provider Second Line Business Practice Location Address:
1ST CONTACT - JENNIFER BOYD
Provider Business Practice Location Address City Name:
DAYTON
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45402-6714
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-225-5878
Provider Business Practice Location Address Fax Number:
937-496-3078
Provider Enumeration Date:
05/27/2010

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
GROSS
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
W.
Authorized Official Title or Position:
HEALTH COMMISSIONER
Authorized Official Telephone Number:
937-225-4395

Provider Taxonomy Codes

  • Taxonomy code: 251K00000X , with the licence number:  2083P0901X , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251K00000X , with the licence number: 005826 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 251K00000X , with the licence number: LH27095065 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 005826 . This is a "AMERICAN DIABETES ASSOCIATION" identifier . This identifiers is of the category "OTHER".