1952337446 NPI number — MRS. MAURA ALEXANDRA SIMMS DPT ATC

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 1952337446 NPI number — MRS. MAURA ALEXANDRA SIMMS DPT ATC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SIMMS
Provider First Name:
MAURA
Provider Middle Name:
ALEXANDRA
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
DPT ATC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MCGOVERN
Provider Other First Name:
MAURA
Provider Other Middle Name:
ALEXANDRA
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DPT ATC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1952337446
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/20/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1015 LANCASTER AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
YORK
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17403-3331
Provider Business Mailing Address Country Code:
US
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:
14 MOUNT CARMEL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PARKTON
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
21120-9721
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
410-229-0055
Provider Business Practice Location Address Fax Number:
410-229-0035
Provider Enumeration Date:
06/25/2006

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: 2251X0800X , with the licence number:  T5594 , 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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