1346273398 NPI number — ELIZABETH FIGLIOLA PT

Table of content: ELIZABETH FIGLIOLA PT (NPI 1346273398)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1346273398 NPI number — ELIZABETH FIGLIOLA PT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FIGLIOLA
Provider First Name:
ELIZABETH
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PT
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:
1346273398
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/02/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4881 SUGARMAPLE RD
Provider Second Line Business Mailing Address:
88 MDG/SGCJ
Provider Business Mailing Address City Name:
WRIGHT PATTERSON AFB
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
45433
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
937-257-4786
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4881 SUGARMAPLE RD
Provider Second Line Business Practice Location Address:
88 MDG/SGCJ
Provider Business Practice Location Address City Name:
WRIGHT PATTERSON AFB
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
45433
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
937-257-4786
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/09/2006

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: 225100000X , with the licence number:  PT008903L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X , with the licence number: PT009210 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 101399722 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2450245000 . This is a "IBC" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1767967 . This is a "HIGHMARK" identifier . This identifiers is of the category "OTHER".
  • Identifier: 50087549 . This is a "CAPITAL BLUE CROSS" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 30062606 . This is a "KEYSTONE MERCY" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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