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1487896478 NPI number — TANIKA SHAREE SPIDELL D.O.

NPI Number: 1487896478
Health Care Provider/Practitioner: TANIKA SHAREE SPIDELL D.O.

Information about “1487896478” NPI (TANIKA SHAREE SPIDELL D.O.) exists in 1487896478 in HTML format HTML  |  1487896478 in plain Text format TXT  |  1487896478 in PDF (Portable Document Format) PDF  |  1487896478 in an XML format XML  formats.

NPI Number : 1487896478 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1487896478",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SPIDELL",
    "FirstName": "TANIKA",
    "MiddleName": "SHAREE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "D.O.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "LLC",
    "OtherFirstName": "SPIDELL",
    "OtherMiddleName": "CONSULTING SOLUTIONS",
    "OtherNamePrefix": "PROF.",
    "OtherNameSuffix": null,
    "OtherCredential": "D.O.",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "1863 KIPLING DR",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "DAYTON",
    "MailingAddressStateName": "OH",
    "MailingAddressPostalCode": "45406-3917",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1863 KIPLING DR",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "DAYTON",
    "PracticeLocationAddressStateName": "OH",
    "PracticeLocationAddressPostalCode": "45406-3917",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "703-382-7871",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/06/2009",
    "LastUpdateDate": "12/02/2024",
    "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": "2084P0800X",
          "TaxonomyName": "Psychiatry Physician",
          "LicenseNumber": "0102206894",
          "LicenseNumberStateCode": "VA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2084P0800X",
          "TaxonomyName": "Psychiatry Physician",
          "LicenseNumber": "34.016749",
          "LicenseNumberStateCode": "OH",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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