Healthcare Provider Details

I. General information

NPI: 1114243409
Provider Name (Legal Business Name): BARBARA ZIFF RATNER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/13/2010
Last Update Date: 08/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 ROLLING RIDGE DR SUITE 100
STATE COLLEGE PA
16801-7641
US

IV. Provider business mailing address

320 ROLLING RIDGE DR SUITE 100
STATE COLLEGE PA
16801-7641
US

V. Phone/Fax

Practice location:
  • Phone: 814-867-0670
  • Fax: 814-867-7616
Mailing address:
  • Phone: 814-867-0670
  • Fax: 814-867-7616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW000175L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier01991303
Identifier TypeOTHER
Identifier State
Identifier IssuerCAPITAL BLUE CROSS

VIII. Authorized Official

Name: BARBARA ZIFF RATNER
Title or Position: OWNER
Credential:
Phone: 814-867-0670