Healthcare Provider Details

I. General information

NPI: 1487062873
Provider Name (Legal Business Name): APT FOUNDATION, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2014
Last Update Date: 01/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

495 CONGRESS AVE
NEW HAVEN CT
06519-1312
US

IV. Provider business mailing address

1 LONG WHARF DR STE 321
NEW HAVEN CT
06511-5991
US

V. Phone/Fax

Practice location:
  • Phone: 203-781-4600
  • Fax: 203-781-4624
Mailing address:
  • Phone: 203-781-4600
  • Fax: 203-781-4624

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number0366
License Number StateCT

VIII. Authorized Official

Name: LYNN M MADDEN
Title or Position: PRESIDENT/CHIEF EXECUTIVE OFFICER
Credential: MPA
Phone: 203-781-4600