Provider Demographics
NPI:1144236662
Name:ADVANCED HEALTH PROFESSIONALS
Entity Type:Organization
Organization Name:ADVANCED HEALTH PROFESSIONALS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:NEIL
Authorized Official - Last Name:GOLDRING
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:203-386-0001
Mailing Address - Street 1:112 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851
Mailing Address - Country:US
Mailing Address - Phone:203-847-4477
Mailing Address - Fax:203-847-3186
Practice Address - Street 1:4697 MAIN STREET
Practice Address - Street 2:
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606
Practice Address - Country:US
Practice Address - Phone:203-386-0001
Practice Address - Fax:203-386-8881
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-01
Last Update Date:2009-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000914111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT1356371884OtherNPI NUMBER
CT1497787477OtherNPI NUMBER
CT1649290308OtherNPI NUMBER