1922452903 NPI number — JAMES ARIEL FELSINGER

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922452903 NPI number — JAMES ARIEL FELSINGER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMES ARIEL FELSINGER
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:
1922452903
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/16/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 LARISSA AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TULLAMARINE
Provider Business Mailing Address State Name:
VICTORIA
Provider Business Mailing Address Postal Code:
3043
Provider Business Mailing Address Country Code:
AU
Provider Business Mailing Address Telephone Number:
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 LARISSA AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TULLAMARINE
Provider Business Practice Location Address State Name:
VICTORIA
Provider Business Practice Location Address Postal Code:
3043
Provider Business Practice Location Address Country Code:
AU
Provider Business Practice Location Address Telephone Number:
619-488-4034
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
04/16/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FELSINGER
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
619-488-4034

Provider Taxonomy Codes

  • Taxonomy code: 293D00000X , registered in the state of ZZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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