Provider Demographics
NPI:1669560512
Name:CITY OF NORWALK
Entity type:Organization
Organization Name:CITY OF NORWALK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MAYOR
Authorized Official - Prefix:
Authorized Official - First Name:HARRY
Authorized Official - Middle Name:
Authorized Official - Last Name:RILLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-854-7707
Mailing Address - Street 1:137 EAST AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06851-5702
Mailing Address - Country:US
Mailing Address - Phone:203-854-7866
Mailing Address - Fax:203-854-7934
Practice Address - Street 1:137 EAST AVE
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06851-5702
Practice Address - Country:US
Practice Address - Phone:203-854-7866
Practice Address - Fax:203-854-7934
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-10
Last Update Date:2014-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0036261QH0100X
CT251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare
No261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008039183Medicaid
CT008039183Medicaid