1952376816 NPI number — NINA ALSABBAGH MD

Table of content: NINA ALSABBAGH MD (NPI 1952376816)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952376816 NPI number — NINA ALSABBAGH MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALSABBAGH
Provider First Name:
NINA
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1952376816
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/19/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2109 HUGHES DR
Provider Second Line Business Mailing Address:
STE 920
Provider Business Mailing Address City Name:
TOLEDO
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43606-3856
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-479-2650
Provider Business Mailing Address Fax Number:
419-479-2655

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2109 HUGHES DR
Provider Second Line Business Practice Location Address:
STE 920
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43606-3856
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-479-2650
Provider Business Practice Location Address Fax Number:
419-479-2655
Provider Enumeration Date:
02/22/2006

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: 207RN0300X , with the licence number:  77100 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 000000137371 . This is a "ANTHEM BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 03527 . This is a "PARAMOUNT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2139993 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2024 www.npivalidator.com