1861558165 NPI number — APT FOUNDATION, INC

Table of content: (NPI 1861558165)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861558165 NPI number — APT FOUNDATION, INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
APT FOUNDATION, INC
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:
ACCESS 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:
1861558165
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/26/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 LONG WHARF DR
Provider Second Line Business Mailing Address:
STE 321
Provider Business Mailing Address City Name:
NEW HAVEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06511-5991
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-781-4600
Provider Business Mailing Address Fax Number:
203-781-4624

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 LONG WHARF DR
Provider Second Line Business Practice Location Address:
STE 10
Provider Business Practice Location Address City Name:
NEW HAVEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06511-5991
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-781-4357
Provider Business Practice Location Address Fax Number:
203-781-4705
Provider Enumeration Date:
12/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MADDEN
Authorized Official First Name:
LYNN
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PRESIDENT/CHIEF EXECUTIVE OFFICER
Authorized Official Telephone Number:
203-781-4600

Provider Taxonomy Codes

  • Taxonomy code: 261QM0850X , with the licence number:  C-0265 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 261QR0405X , with the licence number: SA-0190 , 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: 001155787 . This is a "SHIMELMAN MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 008037391 . This is a "SHACKELL MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 001302497 . This is a "SHI MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 001307439 . This is a "ALTICE MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 008003745 . This is a "DESROSIERS MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 008038040 . This is a "LENCZYCKI MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 008038043 . This is a "WHELAN MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 008058728 . This is a "RIERA MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 008038741 . This is a "OWEN MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 008053091 . This is a "BUTNER MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 008057039 . This is a "MILLER'S MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 008063396 . This is a "MEMISEVICH MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 008066801 . This is a "HAQUE MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 008071202 . This is a "MEDICAID AMYNAH DHARANI" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 001218107 . This is a "SCHOTTENFELD MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 001423136 . This is a "TETRAULT MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 008038042 . This is a "POLANETSKA MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 008048393 . This is a "BARRY MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 008057135 . This is a "MEDICAID HEALTHER KNOX" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 008001077 . This is a "MOORE MEDICAID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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