NPI Code Detail JSON Logo

1396244190 NPI number — STANKA PERVITIC

NPI Number: 1396244190
Health Care Provider/Practitioner: STANKA PERVITIC

Information about “1396244190” NPI (STANKA PERVITIC) exists in 1396244190 in HTML format HTML  |  1396244190 in plain Text format TXT  |  1396244190 in PDF (Portable Document Format) PDF  |  1396244190 in an XML format XML  formats.

NPI Number : 1396244190 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1396244190",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "PERVITIC",
    "FirstName": "STANKA",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "PERVITIC",
    "OtherFirstName": "TANJA",
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "10507 LAKE AVE APT 108",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CLEVELAND",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "44102-1268",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "440-670-5494",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "4400 EUCLID AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CLEVELAND",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "44103-3734",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "216-325-9300",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "02/07/2018",
    "LastUpdateDate": "02/07/2018",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "183500000X",
        "TaxonomyName": "Pharmacist",
        "LicenseNumber": "03129258",
        "LicenseNumberStateCode": "OH",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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