1386685279 NPI number — MRS. JOANNA ALEKSIEJUK RPT

Table of content: MRS. JOANNA ALEKSIEJUK RPT (NPI 1386685279)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386685279 NPI number — MRS. JOANNA ALEKSIEJUK RPT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ALEKSIEJUK
Provider First Name:
JOANNA
Provider Middle Name:
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RPT
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:
1386685279
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/21/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2543 DIXWELL AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMDEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06514-1860
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-248-2400
Provider Business Mailing Address Fax Number:
203-248-9778

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2543 DIXWELL AVENUE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMDEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06514-4028
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-248-2400
Provider Business Practice Location Address Fax Number:
203-248-9778
Provider Enumeration Date:
06/09/2006

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: 225100000X , with the licence number:  005370 , 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: 19002 . This is a "CIGNA-ORTHONET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 20-1237459 . This is a "TAX IDENIFICATION NUMBER" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 080005370CT . This is a "ANTHEM BLUE CROSS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P00218724 . This is a "RR MEDICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P595234 . This is a "OXFORD HEALTHPLAN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 2V2317 . This is a "HEALTHNET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 3552074 . This is a "AETNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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