1861821621 NPI number — DR. MOLLY FOLGER AUD

Table of content: DR. MOLLY FOLGER AUD (NPI 1861821621)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861821621 NPI number — DR. MOLLY FOLGER AUD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FOLGER
Provider First Name:
MOLLY
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
AUD
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:
1861821621
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/25/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
75 TRESSER BLVD UNIT 405
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
STAMFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06901-3356
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
908-723-1661
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2600 POST RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTHPORT
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06890-1258
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-256-3338
Provider Business Practice Location Address Fax Number:
203-256-3346
Provider Enumeration Date:
11/02/2013

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: 231H00000X , with the licence number:  41YA00086700 , registered in the state of NJ ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 231H00000X , with the licence number: 000696 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 231H00000X , with the licence number: 002631 , 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)