COLLABORATION HEALTHCARE CORP NPI 1689348534

NPI Information

NPI: 1689348534
Provider Name: COLLABORATION HEALTHCARE CORP
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 07D2239525

Address:
725 PARK AVE
BRIDGEPORT, CT
ZIP 06604
Phone: (203) 947-2147
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COLLABORATION HEALTHCARE CORP is a primary care nurse practitioner in Bridgeport, CT. COLLABORATION HEALTHCARE CORP NPI is 1689348534. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

725 PARK AVE
BRIDGEPORT, CT
ZIP 06604-619
Phone: (203) 947-2147

The provider's authorized official is Irene A Bihl .
The authorized official title is Founder and has the following contact phone number (203) 947-2147.

The CLIA number assigned to this NPI record is 07D2239525 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/4/2021 and was last updated on 8/4/2021.

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	363LP2300X	Nurse Practitioner	Primary Care			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1	MEDICAID	CONNECTICUT

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: 4/28/2024

NPI Synchronization or Removal

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