1922058122 NPI number — BRIEF THERAPY ASSOCIATES

Table of content: MRS. ANIL BUYRUK RN (NPI 1346847431)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922058122 NPI number — BRIEF THERAPY ASSOCIATES

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
BRIEF THERAPY ASSOCIATES
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:
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:
1922058122
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
04/08/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 14
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SOUTH FREEPORT
Provider Business Mailing Address State Name:
ME
Provider Business Mailing Address Postal Code:
04078-0014
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
207-671-2373
Provider Business Mailing Address Fax Number:
207-773-6207

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
95 INDIA ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
PORTLAND
Provider Business Practice Location Address State Name:
ME
Provider Business Practice Location Address Postal Code:
04101-4250
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
207-672-2373
Provider Business Practice Location Address Fax Number:
207-773-6207
Provider Enumeration Date:
05/11/2006

Additional Information

Authorized Official

Authorized Official Last Name:
BRONZI
Authorized Official First Name:
MARILYN
Authorized Official Middle Name:
T.
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
207-671-2373

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  LC4088 , registered in the state of ME ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 81669 . This is a "UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 0004665 . This is a "MEDICARE PROVIDER TRANSACTION ACCESS NUMBER" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 1032675 . This is a "CIGNA" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 7853446 . This is a "AETNA" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".
  • Identifier: 016598 . This is a "ANTHEM" identifier , issued by the state of ( ME ) . This identifiers is of the category "OTHER".




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