1427664846 NPI number — MS. CHRISTY D'AQUILA CNM

Table of content: MS. CHRISTY D'AQUILA CNM (NPI 1427664846)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427664846 NPI number — MS. CHRISTY D'AQUILA CNM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
D'AQUILA
Provider First Name:
CHRISTY
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
CNM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
D'AQUILA
Provider Other First Name:
CHRISTY
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CNM
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1427664846
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/29/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 1171
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SIMSBURY
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06070-7471
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-431-0516
Provider Business Mailing Address Fax Number:
860-831-3181

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
14 MAPLE ST STE 7
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TERRYVILLE
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06786-5220
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-431-0516
Provider Business Practice Location Address Fax Number:
860-831-3181
Provider Enumeration Date:
09/21/2020

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: 367A00000X , 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)