1467439778 NPI number — UNIVERSITY OF NEW ENGLAND

Table of content: (NPI 1467439778)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467439778 NPI number — UNIVERSITY OF NEW ENGLAND

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
UNIVERSITY OF NEW ENGLAND
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
COMMUNITY OCCUPATIONAL THERAPY CENTER
Provider Other Organization Name Type Code:
3
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:
1467439778
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/25/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 284
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRATTLEBORO
Provider Business Mailing Address State Name:
VT
Provider Business Mailing Address Postal Code:
05302-0284
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-828-3145
Provider Business Mailing Address Fax Number:
207-777-1439

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
441 MAIN ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BIDDEFORD
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04005-2140
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-602-2308
Provider Business Practice Location Address Fax Number:
207-602-5907
Provider Enumeration Date:
12/28/2005

Additional Information

Authorized Official

Authorized Official Last Name:
LABBE TRUFANT
Authorized Official First Name:
NICOLE
Authorized Official Middle Name:
Authorized Official Title or Position:
VP OF FISCAL AFFAIRS
Authorized Official Telephone Number:
207-602-2157

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 225X00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 609810 . This is a "TUFTS" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: M54153 . This is a "CIGNA" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 6609648 . This is a "UNHC" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 1467439778 , issued by the state of ( ME ) . This identifiers is of the category "MEDICAID".
  • Identifier: 602230 . This is a "HPHC" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: U0902 . This is a "BC/BS" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".




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