1023350014 NPI number — CWC HARTFORD LLC

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1023350014 NPI number — CWC HARTFORD LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CWC HARTFORD LLC
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:
1023350014
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/18/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
133 E 58TH ST
Provider Second Line Business Mailing Address:
15TH FLOOR
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10022-1236
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-751-8300
Provider Business Mailing Address Fax Number:
212-813-9455

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 TOWER SQ
Provider Second Line Business Practice Location Address:
4GS
Provider Business Practice Location Address City Name:
HARTFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06183-0001
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-246-7668
Provider Business Practice Location Address Fax Number:
860-246-7688
Provider Enumeration Date:
03/18/2013

Additional Information

Authorized Official

Authorized Official Last Name:
SHAW
Authorized Official First Name:
NANCY
Authorized Official Middle Name:
JUDITH
Authorized Official Title or Position:
OPERATIONS MANAGER
Authorized Official Telephone Number:
212-751-8300

Provider Taxonomy Codes

  • Taxonomy code: 111NX0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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