1740377050 NPI number — MS. GINGER TAYLOR A.P.R.N

Table of content: MS. GINGER TAYLOR A.P.R.N (NPI 1740377050)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740377050 NPI number — MS. GINGER TAYLOR A.P.R.N

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TAYLOR
Provider First Name:
GINGER
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
A.P.R.N
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:
1740377050
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/11/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 OLD PARK LANE
Provider Second Line Business Mailing Address:
SUITE 2
Provider Business Mailing Address City Name:
NEW MILFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06776-2507
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-355-3728
Provider Business Mailing Address Fax Number:
860-355-4253

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 OLD PARK LANE RD
Provider Second Line Business Practice Location Address:
SUITE 2
Provider Business Practice Location Address City Name:
NEW MILFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06776-2507
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-355-3728
Provider Business Practice Location Address Fax Number:
860-355-4253
Provider Enumeration Date:
10/06/2006

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: 363LF0000X , with the licence number:  363LF0000X , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363LF0000X , with the licence number: 000613 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 004222816 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".




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