FAIR HAVEN COMMUNITY HEALTH CLINIC INC NPI 1447767934

NPI Information

NPI: 1447767934
Provider Name: FAIR HAVEN COMMUNITY HEALTH CLINIC, INC
Classification: Clinic/Center - 261QF0400X
Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

CLIA Number: 07D0098713

Address:
14 SYCAMORE WAY
BRANFORD, CT
ZIP 06405
Phone: (203) 777-7411
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FAIR HAVEN COMMUNITY HEALTH CLINIC, INC is a federally qualified health center (fqhc) clinic center in Branford, CT. FAIR HAVEN COMMUNITY HEALTH CLINIC, INC NPI is 1447767934. The provider is registered as an organization entity type.

The provider's business location address is:

14 SYCAMORE WAY
BRANFORD, CT
ZIP 06405-551
Phone: (203) 777-7411
Fax: (203) 777-8506

The provider's authorized official is Yolymar Herrera .
The authorized official title is Credentialing Coordinator and has the following contact phone number (203) 777-7411.

The CLIA number assigned to this NPI record is 07D0098713 - federally qualified health center with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 1/5/2018 and was last updated on 1/5/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QF0400X	Clinic/Center	Federally Qualified Health Center (FQHC)	0901	CONNECTICUT	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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