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General NPI Number Information
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NPI Number | 1326015652
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Entity Type | Organization
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Legal Business Name | USS ESSEX
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Dates
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Enumeration Date | 03/06/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | USS ESSEX (LHD 2)
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City | FPO
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State | AP
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Zip | 96643
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Country | JP
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Telephone | 810956503365
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Fax |
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Provider Business Mailing Address
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Address Line | PSC 476 BOX 1147
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City | FPO
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State | AP
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Zip | 96322
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Country | JP
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Telephone | 81956503365
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Fax |
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Authorized Official
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Title or Position | LCPO
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Name | REYNALDO DINULONG
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Credential | IDC, BSN, RN
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Telephone | 808-653-3365
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1710I1002X
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Taxonomy Name | Independent Duty Corpsman
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License Number |
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License Number State |
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