Provider Demographics
NPI:1124021928
Name:TOWN OF BERLIN OFFICE OF THE TREASU RER
Entity Type:Organization
Organization Name:TOWN OF BERLIN OFFICE OF THE TREASU RER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:
Authorized Official - Last Name:COLELLA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-828-7030
Mailing Address - Street 1:240 KENSINGTON RD
Mailing Address - Street 2:STE 12
Mailing Address - City:BERLIN
Mailing Address - State:CT
Mailing Address - Zip Code:06037-2655
Mailing Address - Country:US
Mailing Address - Phone:860-828-7030
Mailing Address - Fax:860-828-7420
Practice Address - Street 1:240 KENSINGTON RD
Practice Address - Street 2:STE 12
Practice Address - City:BERLIN
Practice Address - State:CT
Practice Address - Zip Code:06037-2655
Practice Address - Country:US
Practice Address - Phone:860-828-7030
Practice Address - Fax:860-828-7420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-05-24
Last Update Date:2017-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTC-804010251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT702016-01OtherMD HEALTH
CT782127OtherAETNA US HEALTHCARE
CTA785612OtherOXFORD
CT702016OtherCONNECTICARE
CT60-00077OtherUNITED HEALTH CARE
CT60-00077OtherUNITED HEALTH CARE
CT657/=========OtherBC-500
CTA785612OtherOXFORD
CT702016-01OtherMD HEALTH
CTA785612OtherOXFORD