1881635712 NPI number — CONNECTICUT EAR, NOSE & THROAT, SINUS & ALLERGY SPECIALISTS, P.C.

Table of content: (NPI 1881635712)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881635712 NPI number — CONNECTICUT EAR, NOSE & THROAT, SINUS & ALLERGY SPECIALISTS, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
CONNECTICUT EAR, NOSE & THROAT, SINUS & ALLERGY SPECIALISTS, P.C.
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:
LINDENMAN & SCHIFF EAR, NOSE AND THROAT SPECIALISTS, P.C.
Provider Other Organization Name Type Code:
4
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:
1881635712
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
11/22/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
21 W MAIN ST
Provider Second Line Business Mailing Address:
ONE EXCHANGE PLACE BLDG-3RD FLOOR
Provider Business Mailing Address City Name:
WATERBURY
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06702-2013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-574-3777
Provider Business Mailing Address Fax Number:
203-755-1708

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
21 W MAIN ST
Provider Second Line Business Practice Location Address:
ONE EXCHANGE PLACE BLDG-3RD FLOOR
Provider Business Practice Location Address City Name:
WATERBURY
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06702-2013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-574-3777
Provider Business Practice Location Address Fax Number:
203-527-4008
Provider Enumeration Date:
06/10/2006

Additional Information

Authorized Official

Authorized Official Last Name:
CIPRIANO
Authorized Official First Name:
DANA
Authorized Official Middle Name:
K.
Authorized Official Title or Position:
PRACTICE ADMINISTRATOR
Authorized Official Telephone Number:
203-574-3777

Provider Taxonomy Codes

  • Taxonomy code: 207Y00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 231H00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 237600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 004239077 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 004194627 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".




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