1942492905 NPI number — JUDITH A. HANCOX, INC.

Table of content: (NPI 1942492905)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942492905 NPI number — JUDITH A. HANCOX, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JUDITH A. HANCOX, 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:
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:
1942492905
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/07/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9 KRISTEN DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SUCCASUNNA
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07876-1265
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-585-4660
Provider Business Mailing Address Fax Number:
973-585-4660

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9 KRISTEN DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SUCCASUNNA
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07876-1265
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-585-4660
Provider Business Practice Location Address Fax Number:
973-585-4660
Provider Enumeration Date:
08/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
HANCOX
Authorized Official First Name:
JUDITH
Authorized Official Middle Name:
A.
Authorized Official Title or Position:
DIRECTOR
Authorized Official Telephone Number:
973-585-4660

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 116634 . This is a "MEDICARE: PTAN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1942492905 . This is a "PHYSICIAN/SUPPLIER GROUP NPI NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 1740404599 . This is a "MEDICARE INDIVIDUAL ID NUMBER" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".
  • Identifier: 021735 . This is a "MEDICARE PIN" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".




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