Provider Demographics
NPI:1972764769
Name:GBATU, FAITH KASOR (PROVIDER)
Entity Type:Individual
Prefix:MRS
First Name:FAITH
Middle Name:KASOR
Last Name:GBATU
Suffix:
Gender:F
Credentials:PROVIDER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 MIX AVE
Mailing Address - Street 2:# C
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06514-2354
Mailing Address - Country:US
Mailing Address - Phone:203-506-0754
Mailing Address - Fax:
Practice Address - Street 1:609 MIX AVE
Practice Address - Street 2:# C
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06514-2354
Practice Address - Country:US
Practice Address - Phone:203-506-0754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No372600000XNursing Service Related ProvidersAdult Companion
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider