1053513390 NPI number — PROYECTO EL PARTO, INC.

Table of content: MYRON E. PRAEGER O.D. (NPI 1942230933)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053513390 NPI number — PROYECTO EL PARTO, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PROYECTO EL PARTO, INC.
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:
1053513390
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/11/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
29 CHAPEL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW LONDON
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06320-4308
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-271-5637
Provider Business Mailing Address Fax Number:
860-442-0188

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
29 CHAPEL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW LONDON
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06320-4308
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-271-5637
Provider Business Practice Location Address Fax Number:
860-442-0188
Provider Enumeration Date:
05/31/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
VENDETTO
Authorized Official First Name:
CORINA
Authorized Official Middle Name:
SANDRA
Authorized Official Title or Position:
EXECUTIVE DIRECTOR
Authorized Official Telephone Number:
860-271-5637

Provider Taxonomy Codes

  • Taxonomy code: 163WM0102X , with the licence number:  E59214 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3747A0650X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 171R00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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