Provider Demographics
NPI:1467439778
Name:UNIVERSITY OF NEW ENGLAND
Entity Type:Organization
Organization Name:UNIVERSITY OF NEW ENGLAND
Other - Org Name:COMMUNITY OCCUPATIONAL THERAPY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VP OF FISCAL AFFAIRS
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:LABBE TRUFANT
Authorized Official - Suffix:
Authorized Official - Credentials:CPA
Authorized Official - Phone:207-602-2157
Mailing Address - Street 1:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:BRATTLEBORO
Mailing Address - State:VT
Mailing Address - Zip Code:05302-0284
Mailing Address - Country:US
Mailing Address - Phone:207-828-3145
Mailing Address - Fax:207-777-1439
Practice Address - Street 1:441 MAIN ST
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-2140
Practice Address - Country:US
Practice Address - Phone:207-602-2308
Practice Address - Fax:207-602-5907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2013-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME609810OtherTUFTS
MEM54153OtherCIGNA
ME6609648OtherUNHC
ME1467439778Medicaid
ME602230OtherHPHC
MEU0902OtherBC/BS
ME1576Medicare PIN
ME6609648OtherUNHC