1396393146 NPI number — MAHREEN RASHID APRN

Table of content: MAHREEN RASHID APRN (NPI 1396393146)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1396393146 NPI number — MAHREEN RASHID APRN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RASHID
Provider First Name:
MAHREEN
Provider Middle Name:
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:
1396393146
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/17/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
GRIFFIN HOSPITAL
Provider Second Line Business Mailing Address:
130 DIVISION STREET #248
Provider Business Mailing Address City Name:
DERBY
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06418
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-732-7550
Provider Business Mailing Address Fax Number:
203-732-1550

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
GRIFFIN HOSPITAL
Provider Second Line Business Practice Location Address:
130 DIVISION STREET
Provider Business Practice Location Address City Name:
DERBY
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06418
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-732-7550
Provider Business Practice Location Address Fax Number:
203-732-1550
Provider Enumeration Date:
08/26/2019

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: 363LP0808X , with the licence number:  11412 , 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: 004025219 , issued by the state of ( CT ) . This identifiers is of the category "MEDICAID".