NPI Code Detail JSON Logo

1851110902 NPI number — PAIGE LILLIAN HERBST PA

NPI Number: 1851110902
Health Care Provider/Practitioner: PAIGE LILLIAN HERBST PA

Information about “1851110902” NPI (PAIGE LILLIAN HERBST PA) exists in 1851110902 in HTML format HTML  |  1851110902 in plain Text format TXT  |  1851110902 in PDF (Portable Document Format) PDF  |  1851110902 in an XML format XML  formats.

NPI Number : 1851110902 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1851110902",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "HERBST",
    "FirstName": "PAIGE",
    "MiddleName": "LILLIAN",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "PA",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "USA MEDDAC 11050 MT. BELVEDERE BLVD.",
    "SecondLineMailingAddress": "RM 1113",
    "MailingAddressCityName": "FORT DRUM",
    "MailingAddressStateName": "NY",
    "MailingAddressPostalCode": "13602",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "10506 EUPHRATES RIVER VALLEY RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "FORT DRUM",
    "PracticeLocationAddressStateName": "NY",
    "PracticeLocationAddressPostalCode": "13602",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "315-772-2778",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "10/07/2024",
    "LastUpdateDate": "02/16/2025",
    "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": "261QM1102X",
          "TaxonomyName": "Military Outpatient Operational (Transportable) Component Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "363A00000X",
          "TaxonomyName": "Physician Assistant",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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