1386760601 NPI number — MS. KAREN MELINDA WARHIT O T R

Table of content: MS. KAREN MELINDA WARHIT O T R (NPI 1386760601)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386760601 NPI number — MS. KAREN MELINDA WARHIT O T R

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WARHIT
Provider First Name:
KAREN
Provider Middle Name:
MELINDA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
O T R
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:
1386760601
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:
43 OLD BRIDGE RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKFIELD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06804-1212
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-775-2400
Provider Business Mailing Address Fax Number:
203-775-5030

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
777 FEDERAL RD
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
BROOKFIELD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06804-2038
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-775-0306
Provider Business Practice Location Address Fax Number:
203-775-3389
Provider Enumeration Date:
03/21/2007

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:  CT00370 , 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: 15640009 . This is a "PROVIDER NUMBER" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 2077796003 . This is a "PROVIDER NUMBER" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: CT-0000771 . This is a "PROVIDER NUMBER" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 130000370CT03 . This is a "PROVIDER ID" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 5785238 . This is a "PROVIDER NUMBER" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: OV1315 . This is a "PROVIDER NUMBER" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 1151015 . This is a "PROVIDER NUMBER" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P387124 . This is a "PROVIDER NUMBER" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: Q95661 . This is a "PROVIDER NUMBER" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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