1053588426 NPI number — NINA MARIE LAMAGNA APRN

Table of content: NINA MARIE LAMAGNA APRN (NPI 1053588426)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053588426 NPI number — NINA MARIE LAMAGNA APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LAMAGNA
Provider First Name:
NINA
Provider Middle Name:
MARIE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
APRN
Provider Gender Code:
F

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:
1053588426
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/07/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
761 MAIN AVE
Provider Second Line Business Mailing Address:
STE 201
Provider Business Mailing Address City Name:
NORWALK
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06851-1080
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-838-4000
Provider Business Mailing Address Fax Number:
203-845-9193

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 PROGRESS DRIVE SUITE 200
Provider Second Line Business Practice Location Address:
NP CARE LLC
Provider Business Practice Location Address City Name:
SHELTON
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06484-6216
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-925-9600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
05/14/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  003781 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LA2200X , with the licence number: 003781 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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