1205866951 NPI number — DR. ALINA RODRIGUEZ-CORREA D.C.

Table of content: DR. ALINA RODRIGUEZ-CORREA D.C. (NPI 1205866951)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205866951 NPI number — DR. ALINA RODRIGUEZ-CORREA D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RODRIGUEZ-CORREA
Provider First Name:
ALINA
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
RODRIGUEZ-CORREA
Provider Other First Name:
ALINA
Provider Other Middle Name:
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C.
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1205866951
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:
850 N MAIN STREET EXT
Provider Second Line Business Mailing Address:
BUILDING #2,SUITE 3A
Provider Business Mailing Address City Name:
WALLINGFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06492-2400
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-627-1828
Provider Business Mailing Address Fax Number:
203-271-3814

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
850 N MAIN STREET EXT
Provider Second Line Business Practice Location Address:
BUILDIING #2 SUITE3A
Provider Business Practice Location Address City Name:
WALLINGFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06492-2400
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-627-1828
Provider Business Practice Location Address Fax Number:
203-271-3814
Provider Enumeration Date:
07/04/2006

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: 111N00000X , with the licence number:  000902 , 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: 11-3670305 . This is a "HMC/FOCUS CONCENTRA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P3131503 . This is a "OXFORD HEALTH PLAN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 11-3670305 . This is a "TRAVELERS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 11-3670305 . This is a "AMERICAN SPECIALTY HEALTH" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 11-3670305 . This is a "BERKLEY ADMIN. OF CT,INC." identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 11-3670305 . This is a "CORVEL" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".
  • Identifier: 662401 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 763938 . This is a "FIRST HEALTH/CCN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 050000902CT10 . This is a "ANTHEM BS" identifier , issued by the state of ( CO ) . This identifiers is of the category "OTHER".




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