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1407653538 NPI number — ARTHUR GARY NOGLAK PRS

NPI Number: 1407653538
Health Care Provider/Practitioner: ARTHUR GARY NOGLAK PRS

Information about “1407653538” NPI (ARTHUR GARY NOGLAK PRS) exists in 1407653538 in HTML format HTML  |  1407653538 in plain Text format TXT  |  1407653538 in PDF (Portable Document Format) PDF  |  1407653538 in an XML format XML  formats.

NPI Number : 1407653538 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1407653538",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "NOGLAK",
    "FirstName": "ARTHUR",
    "MiddleName": "GARY",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "PRS",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "NOGLAK",
    "OtherFirstName": "ARTHUR",
    "OtherMiddleName": "GARY",
    "OtherNamePrefix": "MR.",
    "OtherNameSuffix": null,
    "OtherCredential": "PRS",
    "OtherLastNameTypeCode": "2",
    "FirstLineMailingAddress": "14445 BROADWAY AVE",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CLEVELAND",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "44125-1957",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "216-677-8177",
    "MailingAddressFaxNumber": "--",
    "FirstLinePracticeLocationAddress": "14445 BROADWAY AVE",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CLEVELAND",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "44125-1957",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "216-677-8177",
    "PracticeLocationAddressFaxNumber": "--",
    "EnumerationDate": "02/26/2025",
    "LastUpdateDate": "02/26/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "175T00000X",
        "TaxonomyName": "Peer Specialist",
        "LicenseNumber": "APS.005559",
        "LicenseNumberStateCode": "OH",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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