1982970885 NPI number — KATHERINE I. THONIS, LLC

Table of content: (NPI 1982970885)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1982970885 NPI number — KATHERINE I. THONIS, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
KATHERINE I. THONIS, LLC
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:
1982970885
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/27/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
250 COMMERCIAL ST STE 211
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MANCHESTER
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03101-1142
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-801-2732
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
250 COMMERCIAL ST
Provider Second Line Business Practice Location Address:
SUITE # 1012 B
Provider Business Practice Location Address City Name:
MANCHESTER
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03101-1142
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-801-2732
Provider Business Practice Location Address Fax Number:
603-206-5621
Provider Enumeration Date:
03/26/2012

Additional Information

Authorized Official

Authorized Official Last Name:
THONIS
Authorized Official First Name:
KATHERINE
Authorized Official Middle Name:
I
Authorized Official Title or Position:
LSCW
Authorized Official Telephone Number:
603-801-2732

Provider Taxonomy Codes

  • Taxonomy code: 261QM0801X , with the licence number:  1242 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 30428812 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1538207477 , issued by the state of ( NH ) . This identifiers is of the category "MEDICAID".




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