Provider Demographics
NPI:1972632149
Name:CITY OF NEW BRITAIN
Entity Type:Organization
Organization Name:CITY OF NEW BRITAIN
Other - Org Name:NEW BRITAIN HEALTH DEPARTMENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:DIRECTOR OF HEALTH
Authorized Official - Prefix:MR
Authorized Official - First Name:SERGIO
Authorized Official - Middle Name:
Authorized Official - Last Name:LUPO
Authorized Official - Suffix:
Authorized Official - Credentials:MPH, RS
Authorized Official - Phone:860-612-2773
Mailing Address - Street 1:88 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:NEW BRITAIN
Mailing Address - State:CT
Mailing Address - Zip Code:06051-2523
Mailing Address - Country:US
Mailing Address - Phone:860-826-3464
Mailing Address - Fax:860-826-2687
Practice Address - Street 1:88 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:NEW BRITAIN
Practice Address - State:CT
Practice Address - Zip Code:06051-2523
Practice Address - Country:US
Practice Address - Phone:860-826-3464
Practice Address - Fax:860-826-2687
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-05
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0426261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTX14873Medicare UPIN
CT600000004Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER