1952351421 NPI number — DR. FRANCES D WAIN DC

Table of content: DR. FRANCES D WAIN DC (NPI 1952351421)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952351421 NPI number — DR. FRANCES D WAIN DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WAIN
Provider First Name:
FRANCES
Provider Middle Name:
D
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
F

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:
1952351421
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/30/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1262 WOOD LN
Provider Second Line Business Mailing Address:
205
Provider Business Mailing Address City Name:
LANGHORNE
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19047
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
215-750-3332
Provider Business Mailing Address Fax Number:
215-750-2792

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1262 WOOD LN
Provider Second Line Business Practice Location Address:
205
Provider Business Practice Location Address City Name:
LANGHORNE
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19047
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
215-750-3332
Provider Business Practice Location Address Fax Number:
215-750-2792
Provider Enumeration Date:
05/12/2006

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: 111N00000X , with the licence number:  DC005463L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 111N00000X , with the licence number: F10000385 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 178119101 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 133153 . This is a "BCBS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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