Provider Demographics
NPI:1407938665
Name:JANE BISANTZ & ASSOCIATES, LLC
Entity Type:Organization
Organization Name:JANE BISANTZ & ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JANE
Authorized Official - Middle Name:
Authorized Official - Last Name:BISANTZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-267-6768
Mailing Address - Street 1:91 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST HAMPTON
Mailing Address - State:CT
Mailing Address - Zip Code:06424-1143
Mailing Address - Country:US
Mailing Address - Phone:860-267-6768
Mailing Address - Fax:860-267-9560
Practice Address - Street 1:91 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST HAMPTON
Practice Address - State:CT
Practice Address - Zip Code:06424-1143
Practice Address - Country:US
Practice Address - Phone:860-267-6768
Practice Address - Fax:860-267-9560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
251C00000X
CT000636251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered251C00000XAgenciesDay Training, Developmentally Disabled Services
Not Answered251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTCU2227OtherHEALTHNET
CT68BTO3021CT01OtherANTHEM BLUE CROSS/BLUE SH
CTP2004839OtherOXFORD
CT793169OtherCONNECTICARE