Basic Information
Provider Information
NPI: 1003007675
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FOLI
FirstName: RITA
MiddleName: A
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 5449 LONGWORTH DR
Address2:  
City: GALLOWAY
State: OH
PostalCode: 431198456
CountryCode: US
TelephoneNumber: 6149220731
FaxNumber:  
Practice Location
Address1: 5449 LONGWORTH DR
Address2:  
City: GALLOWAY
State: OH
PostalCode: 431198456
CountryCode: US
TelephoneNumber: 6149220731
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/07/2007
LastUpdateDate: 08/07/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN303888OHY Nursing Service ProvidersRegistered Nurse 

No ID Information.


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