NPI Code Detail JSON Logo

1508832593 NPI number — PROFESSIONAL DIAGNOSTICS LLC

NPI Number: 1508832593
Health Care Provider/Practitioner: PROFESSIONAL DIAGNOSTICS LLC

Information about “1508832593” NPI (PROFESSIONAL DIAGNOSTICS LLC) exists in 1508832593 in HTML format HTML  |  1508832593 in plain Text format TXT  |  1508832593 in PDF (Portable Document Format) PDF  |  1508832593 in an XML format XML  formats.

NPI Number : 1508832593 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1508832593",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "PROFESSIONAL DIAGNOSTICS LLC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "106 BOW ST",
    "SecondLineMailingAddress": "UNION HOSPITAL",
    "MailingAddressCityName": "ELKTON",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "21921-5544",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "410-392-7086",
    "MailingAddressFaxNumber": "410-392-4704",
    "FirstLinePracticeLocationAddress": "106 BOW ST",
    "SecondLinePracticeLocationAddress": "UNION HOSPITAL",
    "PracticeLocationAddressCityName": "ELKTON",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "21921-5544",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "410-392-7086",
    "PracticeLocationAddressFaxNumber": "410-392-4704",
    "EnumerationDate": "02/28/2006",
    "LastUpdateDate": "07/21/2022",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "SZUMEL",
    "AuthorizedOfficialFirstName": "RICHARD",
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": "CONTACT PERSON",
    "AuthorizedOfficialNamePrefix": "DR.",
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "M.D.",
    "AuthorizedOfficialTelephoneNumber": "410-392-7086",
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207ZP0102X",
        "TaxonomyName": "Anatomic Pathology & Clinical Pathology Physician",
        "LicenseNumber": null,
        "LicenseNumberStateCode": "MD",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193400000X SINGLE SPECIALTY  GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Single Specialty Group - A business group of one or more individual practitioners, all of who practice with the same area of specialization."
      }
    }
  }
}
                
            

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