1578556882 NPI number — DR. NANCY MILLIAN PSYD

Table of content: DR. NANCY MILLIAN PSYD (NPI 1578556882)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578556882 NPI number — DR. NANCY MILLIAN PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MILLIAN
Provider First Name:
NANCY
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
PSYD
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:
1578556882
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/24/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2 POMPERAUG OFFICE PARK
Provider Second Line Business Mailing Address:
STE 206
Provider Business Mailing Address City Name:
SOUTHBURY
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06488-2291
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-797-1855
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 POMPERAUG OFFICE PARK
Provider Second Line Business Practice Location Address:
STE 206
Provider Business Practice Location Address City Name:
SOUTHBURY
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06488-2291
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-797-1855
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
08/23/2005

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: 103T00000X , with the licence number:  1312 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 103T00000X , with the licence number: 15004 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 02228875 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 108402 . This is a "EMPIRE BC" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: P367371 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 108402 . This is a "TRICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 417629 . This is a "MVP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 060001312CT08 . This is a "ANTHEM BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 101554000 . This is a "MAGELLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 101554000 . This is a "AETNA US HEALTHCARE" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 060001312CT02 . This is a "ANTHEM BCBS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 108402 . This is a "HEALTHNET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 80170 . This is a "MHN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 004069910 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 080170 . This is a "HEALTHNET" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 2701783 . This is a "AETNA US HEALTHCARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




Copyright © 2007-2025 www.npivalidator.com