1871798355 NPI number — SFRMI, P.C.

Table of content: (NPI 1871798355)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871798355 NPI number — SFRMI, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SFRMI, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1871798355
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/30/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 32109
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HARTFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06150-2109
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-367-1095
Provider Business Mailing Address Fax Number:
860-298-6127

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7 WATERSIDE XING
Provider Second Line Business Practice Location Address:
3RD FLOOR
Provider Business Practice Location Address City Name:
WINDSOR
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06095-1540
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-367-1095
Provider Business Practice Location Address Fax Number:
860-298-6127
Provider Enumeration Date:
06/15/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
FLANEGIN
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
610-831-1112

Provider Taxonomy Codes

  • Taxonomy code: 261QR0200X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)