NPI Code Detail JSON Logo

1508042664 NPI number — DEBRA AUGUST KING PA, PHD

NPI Number: 1508042664
Health Care Provider/Practitioner: DEBRA AUGUST KING PA, PHD

Information about “1508042664” NPI (DEBRA AUGUST KING PA, PHD) exists in 1508042664 in HTML format HTML  |  1508042664 in plain Text format TXT  |  1508042664 in PDF (Portable Document Format) PDF  |  1508042664 in an XML format XML  formats.

NPI Number : 1508042664 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508042664",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "KING",
    "FirstName": "DEBRA",
    "MiddleName": "AUGUST",
    "NamePrefix": "MS.",
    "NameSuffix": null,
    "Credential": "PA, PHD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "28 CRESCENT ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "MIDDLETOWN",
    "MailingAddressStateName": "CT",
    "MailingAddressPostalCode": "06457-3650",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "860-358-6000",
    "MailingAddressFaxNumber": "860-358-8661",
    "FirstLinePracticeLocationAddress": "540 SAYBROOK RD STE 100",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "MIDDLETOWN",
    "PracticeLocationAddressStateName": "CT",
    "PracticeLocationAddressPostalCode": "06457-4760",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "860-358-2850",
    "PracticeLocationAddressFaxNumber": "860-358-8698",
    "EnumerationDate": "01/18/2008",
    "LastUpdateDate": "09/04/2025",
    "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": "363AS0400X",
          "TaxonomyName": "Surgical Physician Assistant",
          "LicenseNumber": "005445",
          "LicenseNumberStateCode": "NY",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363AS0400X",
          "TaxonomyName": "Surgical Physician Assistant",
          "LicenseNumber": "548",
          "LicenseNumberStateCode": "CT",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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