1225225055 NPI number — QUALITY MEDICAL TRAINING CENTER

Table of content: (NPI 1225225055)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225225055 NPI number — QUALITY MEDICAL TRAINING CENTER

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
QUALITY MEDICAL TRAINING CENTER
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:
1225225055
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
09/25/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2945 MAIN ST
Provider Second Line Business Mailing Address:
SUITE B, 2ND FL
Provider Business Mailing Address City Name:
STRATFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06614-4978
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-278-6849
Provider Business Mailing Address Fax Number:
203-859-5300

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2945 MAIN ST
Provider Second Line Business Practice Location Address:
SUITE B, 2ND FL
Provider Business Practice Location Address City Name:
STRATFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06614-4978
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-278-6849
Provider Business Practice Location Address Fax Number:
203-859-5300
Provider Enumeration Date:
09/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
ZINNERMAN
Authorized Official First Name:
AMANDA
Authorized Official Middle Name:
L.
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
203-278-6849

Provider Taxonomy Codes

  • Taxonomy code: 251E00000X , with the licence number:  251E00000X , 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)





Copyright © 2007-2025 www.npivalidator.com