1184781205 NPI number — DIANNE HUNT-MASON A.P.R.N.C.S, M.ED

Table of content: DIANNE HUNT-MASON A.P.R.N.C.S, M.ED (NPI 1184781205)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1184781205 NPI number — DIANNE HUNT-MASON A.P.R.N.C.S, M.ED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HUNT-MASON
Provider First Name:
DIANNE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
A.P.R.N.C.S, M.ED
Provider Gender Code:
F

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:
1184781205
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
59 MAIN STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ESSEX
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06426
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-767-7576
Provider Business Mailing Address Fax Number:
860-767-1933

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
59 MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ESSEX
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06426
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-767-7576
Provider Business Practice Location Address Fax Number:
860-767-1933
Provider Enumeration Date:
01/02/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 103T00000X , with the licence number:  001253 , 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: 62-19341 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 400001253CT01 . This is a "BCBS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P2749111 . This is a "OXFORD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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