1336284751 NPI number — KATHLEEN M ROMANIA OT05231966

Table of content: KATHLEEN M ROMANIA OT05231966 (NPI 1336284751)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1336284751 NPI number — KATHLEEN M ROMANIA OT05231966

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROMANIA
Provider First Name:
KATHLEEN
Provider Middle Name:
M
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
OT05231966
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:
1336284751
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:
8 RESEARCH PKWY
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WALLINGFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06492-1929
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-294-1998
Provider Business Mailing Address Fax Number:
203-294-1189

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8 RESEARCH PKWY
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WALLINGFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06492-1929
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-294-1998
Provider Business Practice Location Address Fax Number:
203-294-1189
Provider Enumeration Date:
02/21/2007

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: 225X00000X , with the licence number:  819 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 225XE1200X , with the licence number: 819 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 225XH1200X , with the licence number: 819 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 225XP0200X , with the licence number: 819 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00415176800 . This is a "BLUE CARE FAMILY PLAN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 183158 . This is a "FIRST CHOICE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 6404254 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 0V1691 . This is a "HEALTHNET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 39111777 . This is a "AETNA" identifier , issued by the state of ( DE ) . This identifiers is of the category "OTHER".
  • Identifier: 00415176800 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 712712 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: A667399 . This is a "OXFORD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 130000819CT04 . This is a "ANTHEM BCBS" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com