1922351634 NPI number — STAMFORD HOSPITAL

Table of content: (NPI 1922351634)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922351634 NPI number — STAMFORD HOSPITAL

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STAMFORD HOSPITAL
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:
1922351634
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/18/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
150 SOUTHFIELD AVE
Provider Second Line Business Mailing Address:
APT 1415
Provider Business Mailing Address City Name:
STAMFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06902-7756
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-524-2762
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
150 SOUTHFIELD AVE
Provider Second Line Business Practice Location Address:
APT 1415
Provider Business Practice Location Address City Name:
STAMFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06902
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-524-2762
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/18/2012

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
VETSCH
Authorized Official First Name:
PILAR
Authorized Official Middle Name:
Authorized Official Title or Position:
APRN
Authorized Official Telephone Number:
203-524-2762

Provider Taxonomy Codes

  • Taxonomy code: 282N00000X , with the licence number:  5166 , 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)