1306943279 NPI number — MRS. PATRICIA MARY SHENBERGER LCSW

Table of content: MRS. PATRICIA MARY SHENBERGER LCSW (NPI 1306943279)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306943279 NPI number — MRS. PATRICIA MARY SHENBERGER LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHENBERGER
Provider First Name:
PATRICIA
Provider Middle Name:
MARY
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PASHOW
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
MARY
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
CSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1306943279
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4277 MIDDLE SETTLEMENT RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW HARTFORD
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13413-5315
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
315-735-6484
Provider Business Mailing Address Fax Number:
315-735-8545

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4277 MIDDLE SETTLEMENT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW HARTFORD
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13413-5315
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
315-735-6484
Provider Business Practice Location Address Fax Number:
315-735-8545
Provider Enumeration Date:
09/20/2006

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: 1041C0700X , with the licence number:  070539 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2024 www.npivalidator.com