1285706127 NPI number — MT CARMEL MEDICAL ASSOCIATES, LLP

Table of content: (NPI 1285706127)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1285706127 NPI number — MT CARMEL MEDICAL ASSOCIATES, LLP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MT CARMEL MEDICAL ASSOCIATES, LLP
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:
1285706127
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
01/08/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2690 WHITNEY AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMDEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06518-2924
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-281-6228
Provider Business Mailing Address Fax Number:
203-248-2881

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2690 WHITNEY AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HAMDEN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06518-2924
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-281-6228
Provider Business Practice Location Address Fax Number:
203-248-2881
Provider Enumeration Date:
11/15/2006

Additional Information

Authorized Official

Authorized Official Last Name:
MONACO
Authorized Official First Name:
PAUL
Authorized Official Middle Name:
A
Authorized Official Title or Position:
PARTNER
Authorized Official Telephone Number:
203-281-6228

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  27738, 13376, 39321 , 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: 010013376CT01 . This is a "DR.SARACCO'S BLUE CROSS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 001133768 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010039321CT01 . This is a "DR.SUN'S BLUE CROSS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 0V8915 . This is a "DR.SARACCO'S HEALTH NET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 2V0374 . This is a "DR.SUN'S HEALTH NET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 0V8914 . This is a "DR.MONACO'S HEALTH NET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 0011277385 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 010027738CT02 . This is a "DR.MONACO'S BLUE CROSS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 004188133 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 001383214 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".




Copyright © 2007-2025 www.npivalidator.com