1972140218 NPI number — ALOYSIUS MICHAEL STILP MS L AC DIPL AC

Table of content: ALOYSIUS MICHAEL STILP MS L AC DIPL AC (NPI 1972140218)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1972140218 NPI number — ALOYSIUS MICHAEL STILP MS L AC DIPL AC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STILP
Provider First Name:
ALOYSIUS
Provider Middle Name:
MICHAEL
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MS L AC DIPL AC
Provider Gender Code:
M

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:
1972140218
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/05/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 396
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SHIPPENSBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17257-0396
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-377-4999
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
NEW DAY YOGA & WELLNESS 300 WEST KING ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SHIPPENSBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17257-1725
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-530-8981
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/05/2019

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: 171100000X , with the licence number:  AK001024 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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