1437252806 NPI number — STARLING PHYSICIANS, PLLC

Table of content: (NPI 1437252806)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1437252806 NPI number — STARLING PHYSICIANS, PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
STARLING PHYSICIANS, PLLC
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:
6
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:
1437252806
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2110 SILAS DEANE HWY
Provider Second Line Business Mailing Address:
STARLING PHYSICIANS
Provider Business Mailing Address City Name:
ROCKY HILL
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06067-2313
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-258-3470
Provider Business Mailing Address Fax Number:
860-571-6800

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 LAKE ST
Provider Second Line Business Practice Location Address:
GROVE HILL MEDICAL CENTER
Provider Business Practice Location Address City Name:
NEW BRITAIN
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06052-1396
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-827-4600
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/07/2006

Additional Information

Authorized Official

Authorized Official Last Name:
LEBENGER
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
D
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
908-790-6567

Provider Taxonomy Codes

  • Taxonomy code: 291U00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 004118106 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 070CL0131CT03 . This is a "BCBS MEDIBLUE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 070CL0131CT03 . This is a "BCBS COMMERCIAL" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 140440. . This is a "WELLCARE MEDICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 690005500 . This is a "RAIL ROAD MEDICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 070CL0131CT03 . This is a "BLUE CARE FAMILY PLAN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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