1669563938 NPI number — DR. JEANNE MARIE BAFFA MD

Table of content: DR. JEANNE MARIE BAFFA MD (NPI 1669563938)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669563938 NPI number — DR. JEANNE MARIE BAFFA MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BAFFA
Provider First Name:
JEANNE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
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:
1669563938
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/13/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 191
Provider Second Line Business Mailing Address:
PROVIDER ENROLLMENT DEPT
Provider Business Mailing Address City Name:
ROCKLAND
Provider Business Mailing Address State Name:
DE
Provider Business Mailing Address Postal Code:
19732-0191
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
302-651-6212
Provider Business Mailing Address Fax Number:
302-651-4945

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
A.I. DUPONT HOSPITAL FOR CHILDREN
Provider Second Line Business Practice Location Address:
1600 ROCKLAND ROAD
Provider Business Practice Location Address City Name:
WILMINGTON
Provider Business Practice Location Address State Name:
DE
Provider Business Practice Location Address Postal Code:
19803-3607
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
302-651-4000
Provider Business Practice Location Address Fax Number:
302-651-4945
Provider Enumeration Date:
09/28/2006

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: 2080P0202X , with the licence number:  C10005240 , registered in the state of DE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2080P0202X , with the licence number: D0043339 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080P0202X , with the licence number: MA06877200 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 2080P0202X , with the licence number: MD038107E , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 806322600 , issued by the state of ( ID ) . This identifiers is of the category "MEDICAID".
  • Identifier: P8B200780 , issued by the state of ( TX ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0543519 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 0509943 , issued by the state of ( IA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 01289629 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001272391 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 5077001 , issued by the state of ( NJ ) . This identifiers is of the category "MEDICAID".
  • Identifier: Q05240 , issued by the state of ( SC ) . This identifiers is of the category "MEDICAID".




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