NPI Code Detail JSON Logo

1265304042 NPI number — MAGAMBO'S PEACEFUL PALACE, PC

NPI Number: 1265304042
Health Care Provider/Practitioner: MAGAMBO'S PEACEFUL PALACE, PC

Information about “1265304042” NPI (MAGAMBO'S PEACEFUL PALACE, PC) exists in 1265304042 in HTML format HTML  |  1265304042 in plain Text format TXT  |  1265304042 in PDF (Portable Document Format) PDF  |  1265304042 in an XML format XML  formats.

NPI Number : 1265304042 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1265304042",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "MAGAMBO'S PEACEFUL PALACE, PC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "26 THOMASTON DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "PITTSBURGH",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "15235-1406",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "814-691-1618",
    "MailingAddressFaxNumber": "412-207-3551",
    "FirstLinePracticeLocationAddress": "26 THOMASTON DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "PITTSBURGH",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "15235-1406",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "814-691-1618",
    "PracticeLocationAddressFaxNumber": "412-207-3551",
    "EnumerationDate": "09/22/2025",
    "LastUpdateDate": "09/22/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "MAGAMBO",
    "AuthorizedOfficialFirstName": "SHANEISA",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "OWNER",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": "814-691-1618",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "251B00000X",
          "TaxonomyName": "Case Management Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "252Y00000X",
          "TaxonomyName": "Early Intervention Provider Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "253Z00000X",
          "TaxonomyName": "In Home Supportive Care Agency",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.