1982713533 NPI number — JUDITH M STRANKO DO

Table of content: JUDITH M STRANKO DO (NPI 1982713533)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982713533 NPI number — JUDITH M STRANKO DO

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STRANKO
Provider First Name:
JUDITH
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
DO
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:
1982713533
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/19/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
118 WASHINGTON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARRISBURG
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
17104-1677
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
717-231-8539
Provider Business Mailing Address Fax Number:
717-231-8588

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2645 N 3RD ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HARRISBURG
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
17110-2001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
717-782-4650
Provider Business Practice Location Address Fax Number:
717-782-4665
Provider Enumeration Date:
08/29/2006

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: 2080P0006X , with the licence number:  OS005101L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 208000000X , with the licence number: OS-005101-L , 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)

  • Identifier: 50054768 . This is a "CAPITAL BLUE CROSS (CAIC)" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 672165 . This is a "FIRSTHEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 7739901 . This is a "GATEWAY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: ST739901 . This is a "HIGHMARK BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 143501 . This is a "UNISON" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0014105220004 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com