1881650158 NPI number — MS. OLGA IRIS COLON APRN

Table of content: MS. OLGA IRIS COLON APRN (NPI 1881650158)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881650158 NPI number — MS. OLGA IRIS COLON APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
COLON
Provider First Name:
OLGA
Provider Middle Name:
IRIS
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
APRN
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:
1881650158
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/11/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
60 GILLETT ST
Provider Second Line Business Mailing Address:
SUITE 300
Provider Business Mailing Address City Name:
HARTFORD
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06105-2637
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-247-2500
Provider Business Mailing Address Fax Number:
860-247-2800

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
60 GILLETT ST
Provider Second Line Business Practice Location Address:
SUITE 300
Provider Business Practice Location Address City Name:
HARTFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06105-2367
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-247-2500
Provider Business Practice Location Address Fax Number:
860-247-2800
Provider Enumeration Date:
04/25/2006

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:  003016 , 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: 231039 . This is a "PREFERRED ONE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 400003016CT01 . This is a "BLUE CROSS/BLUE SHIELD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: P33522458 . This is a "OXFORD" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 004243507 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 400003016CT02 . This is a "BLUE CROSS/BLUE CARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 043678785 . This is a "AMALGAMATED LIFE, CHN" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 2V4998 . This is a "HEALTHNET" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 004243490 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 008044860 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 030160 . This is a "CONNECTICARE" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 00424350700 . This is a "BLUE CARE FAMILY" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




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