1386642932 NPI number — CATHERINE T FORD M.D., FAAP

Table of content: CATHERINE T FORD M.D., FAAP (NPI 1386642932)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386642932 NPI number — CATHERINE T FORD M.D., FAAP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FORD
Provider First Name:
CATHERINE
Provider Middle Name:
T
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D., FAAP
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:
1386642932
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/27/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10 MOTT AVENUE 4TH FLOOR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
NORWALK
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06850
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-855-7551
Provider Business Mailing Address Fax Number:
203-855-7624

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10 MOTT AVENUE 4TH FLOOR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
NORWALK
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06850
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-855-7551
Provider Business Practice Location Address Fax Number:
203-855-7624
Provider Enumeration Date:
07/08/2005

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: 208000000X , with the licence number:  209093 , registered in the state of MA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 206716 . This is a "FIRST SENIORITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4791177 . This is a "HEALTHSOURCE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 206716 . This is a "HARVARD/PILGRIM" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0151513 . This is a "MASS HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 206716 . This is a "HARVARD PILGRIM POS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 209093 . This is a "TUFTS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 209093 . This is a "TUFTS BENEFIT ADMINISTRAT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 209093 . This is a "TUFTS TOTAL HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: J23955 . This is a "BLUE SHIELD INDEMNITY" identifier . This identifiers is of the category "OTHER".
  • Identifier: J23955 . This is a "BS BLUE CARE ELECT" identifier . This identifiers is of the category "OTHER".
  • Identifier: 206716 . This is a "HARVARD PILGRIM PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: J23955 . This is a "HMO BLUE/BLUE CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 209093 . This is a "TUFTS COMMONWEALTH PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 34374 . This is a "CHILDRENS MEDICAL HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0028121 . This is a "NEIGHBORHOOD HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1203554 . This is a "UNITED HEALTHCARE PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 4791177 . This is a "CIGNA HEALTH CARE" identifier . This identifiers is of the category "OTHER".




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