1942219654 NPI number — CATHLEEN M PLATT APRN

Table of content: CATHLEEN M PLATT APRN (NPI 1942219654)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942219654 NPI number — CATHLEEN M PLATT APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PLATT
Provider First Name:
CATHLEEN
Provider Middle Name:
M
Provider Name Prefix Text:
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:
1942219654
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
270 FARMINGTON AVE
Provider Second Line Business Mailing Address:
SUITE 102
Provider Business Mailing Address City Name:
FARMINGTON
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06032-1909
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
860-549-8276
Provider Business Mailing Address Fax Number:
860-674-8084

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
31 SEYMOUR ST
Provider Second Line Business Practice Location Address:
STE 100
Provider Business Practice Location Address City Name:
HARTFORD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06106-5521
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
860-549-3210
Provider Business Practice Location Address Fax Number:
860-247-3803
Provider Enumeration Date:
08/05/2006

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: 363LX0106X , with the licence number:  001587 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 363L00000X , with the licence number: 001587 , 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: 001587 . This is a "CT LICENSE #" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com