Provider Demographics
NPI:1801950951
Name:APT FOUNDATION, INC
Entity type:Organization
Organization Name:APT FOUNDATION, INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:203-781-4600
Mailing Address - Street 1:1 LONG WHARF DR
Mailing Address - Street 2:STE 321
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5991
Mailing Address - Country:US
Mailing Address - Phone:203-781-4600
Mailing Address - Fax:203-781-4624
Practice Address - Street 1:1 LONG WHARF DR
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5991
Practice Address - Country:US
Practice Address - Phone:203-781-4640
Practice Address - Fax:203-781-4682
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-21
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0000610261Q00000X, 261Q00000X
CT0737261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008066315OtherCOLON RIVERA MEDICAID
CT008066948OtherLOUIE MEDICAID
CT001218107OtherSCHOTTENFELD MEDICAID
CT001272286Medicaid
CT001307439OtherALTICE MEDICAID
CT008040283OtherCAMENGA MEDICAID
CT008063396OtherMEMISEVICH MEDICAID
CT008066801OtherHAQUE MEDICAID
CT001340132OtherSAVAGE MEDICAID
CT001423135OtherTETRAULT MEDICAID
CT004217099OtherPCS LONG WHARF MEDICAID
CT008003745OtherDESROSIERS MEDICAID
CT008053091OtherBUTNER MEDICAID
CT001302497OtherSHI MEDICAID
CT008037391OtherSHACKELL MEDICAID
CT008058058OtherSADINSKY MEDICAID
CT008069118OtherCAMPBELL MEDICAID #
CT008066293OtherMARDAM BEY MEDICAID
CT008068420OtherSCHEFILITI MEDICAID
CTD400316058Medicare PIN
CTD400081097Medicare PIN
CT008066801OtherHAQUE MEDICAID
CT008066315OtherCOLON RIVERA MEDICAID
CT008063396OtherMEMISEVICH MEDICAID
CT001423135OtherTETRAULT MEDICAID
CT008068420OtherSCHEFILITI MEDICAID
CTD400318431Medicare PIN
CTC01033Medicare PIN
CT110004627Medicare PIN
CT008066293OtherMARDAM BEY MEDICAID
CT008037391OtherSHACKELL MEDICAID
CT001340132OtherSAVAGE MEDICAID
CT001272286Medicaid
CTD400315836Medicare PIN
CTD400278647Medicare PIN
CT440000058Medicare PIN
CT110003899Medicare PIN
CTD400278240OtherDUFFEY MEDICARE
CTD400318461OtherHAQUE MEDICARE