1699868216 NPI number — MEDICAL & ENDOCRINE CONSULTANTS,LLC

Table of content: (NPI 1699868216)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699868216 NPI number — MEDICAL & ENDOCRINE CONSULTANTS,LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MEDICAL & ENDOCRINE CONSULTANTS,LLC
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:
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:
1699868216
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
85 SEYMOUR STREET
Provider Second Line Business Mailing Address:
SUITE 1007
Provider Business Mailing Address City Name:
HARTFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06106-5568
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-246-5300
Provider Business Mailing Address Fax Number:
860-524-8230

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
85 SEYMOUR STREET
Provider Second Line Business Practice Location Address:
SUITE 1007
Provider Business Practice Location Address City Name:
HARTFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06106-5568
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-246-5300
Provider Business Practice Location Address Fax Number:
860-524-8230
Provider Enumeration Date:
10/02/2006

Additional Information

Authorized Official

Authorized Official Last Name:
GREY
Authorized Official First Name:
NEIL
Authorized Official Middle Name:
JAY
Authorized Official Title or Position:
PHYSICIAN
Authorized Official Telephone Number:
860-246-5300

Provider Taxonomy Codes

  • Taxonomy code: 174400000X , with the licence number:  014871 , 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: OV7228 . This is a "HEALTHNET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P2368112 . This is a "OXFORD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 0676854 . This is a "AETNA" identifier . This identifiers is of the category "OTHER".
  • Identifier: 704170 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 010014871CT01 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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