1942259312 NPI number — LAMANNA-DOOLELY PLASTIC SURGERY ASSOCIATES, INC.

Table of content: (NPI 1942259312)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942259312 NPI number — LAMANNA-DOOLELY PLASTIC SURGERY ASSOCIATES, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
LAMANNA-DOOLELY PLASTIC SURGERY ASSOCIATES, INC.
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:
1942259312
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
40 KENHORST BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
READING
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19607-1532
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-796-1000
Provider Business Mailing Address Fax Number:
610-796-8018

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
40 KENHORST BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
READING
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19607-1532
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-796-1000
Provider Business Practice Location Address Fax Number:
610-796-8018
Provider Enumeration Date:
05/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LAMANNA
Authorized Official First Name:
JOHN
Authorized Official Middle Name:
V.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
610-796-1000

Provider Taxonomy Codes

  • Taxonomy code: 208200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1942282751 . This is a "NPI JOHN V. LAMANNA, M.D." identifier . This identifiers is of the category "OTHER".
  • Identifier: 2448700 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1659501 . This is a "CBC THOMAS W. DOOLEY, M.D" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 1760464754 . This is a "NPI THOMAS W. DOOLEY, M.D" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1433401 . This is a "CBC JOHN V. LAMANNA, M.D." identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0537798000 . This is a "IBC PERSONAL CHOICE" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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