1275564205 NPI number — DR. PAUL J CEPLENSKI M.D.

Table of content: DR. PAUL J CEPLENSKI M.D. (NPI 1275564205)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275564205 NPI number — DR. PAUL J CEPLENSKI M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CEPLENSKI
Provider First Name:
PAUL
Provider Middle Name:
J
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
M

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:
1275564205
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
300 KENSINGTON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NEW BRITAIN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06051-3916
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-224-6231
Provider Business Mailing Address Fax Number:
860-224-6260

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 LAKE ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NEW BRITAIN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06052-1396
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-826-4453
Provider Business Practice Location Address Fax Number:
860-224-6260
Provider Enumeration Date:
07/06/2006

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: 208800000X , with the licence number:  022556 , 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)

  • Identifier: 010022556CT04 . This is a "BCBS ONE LAKE ST ID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1255448155 . This is a "GHMC GROUP NPI" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 2V8479 . This is a "HEALTH NET ID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 0203728 . This is a "CIGNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P957088 . This is a "OXFORD HEALTH PLAN ID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 076772 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1359330 . This is a "AETNA ID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 010022556CT05 . This is a "BCBS 55 MERIDEN AVE ID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com