1982065439 NPI number — CELTIC CHARMS INC

Table of content: (NPI 1982065439)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982065439 NPI number — CELTIC CHARMS INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CELTIC CHARMS 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:
1982065439
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/11/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
671 FORT PLAINS RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOWELL
Provider Business Mailing Address State Name:
NJ
Provider Business Mailing Address Postal Code:
07731-1140
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-987-5333
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
671 FORT PLAINS RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOWELL
Provider Business Practice Location Address State Name:
NJ
Provider Business Practice Location Address Postal Code:
07731-1140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
732-987-5333
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/11/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LANDUYT
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
M
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
732-987-5333

Provider Taxonomy Codes

  • Taxonomy code: 251V00000X , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: DDD1000820 . This is a "DDD" identifier , issued by the state of ( NJ ) . This identifiers is of the category "OTHER".