1528124278 NPI number — MRS. CATHERINE LEADEN MORNEAULT M.D.

Table of content: MRS. CATHERINE LEADEN MORNEAULT M.D. (NPI 1528124278)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1528124278 NPI number — MRS. CATHERINE LEADEN MORNEAULT M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORNEAULT
Provider First Name:
CATHERINE
Provider Middle Name:
LEADEN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GIORDANO
Provider Other First Name:
CATHERINE
Provider Other Middle Name:
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.D
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1528124278
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
385 CHURCH ST
Provider Second Line Business Mailing Address:
101
Provider Business Mailing Address City Name:
GUILFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06437
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-453-0361
Provider Business Mailing Address Fax Number:
203-453-8510

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
385 CHURCH ST
Provider Second Line Business Practice Location Address:
101
Provider Business Practice Location Address City Name:
GUILFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06437
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-453-0361
Provider Business Practice Location Address Fax Number:
203-453-8510
Provider Enumeration Date:
12/28/2006

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: 208M00000X , with the licence number:  037428 , 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: 037428 . This is a "CT PHYSICIAN LICENSE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 27693 . This is a "CT CSR" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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