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General NPI Number Information
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NPI Number | 1487062873
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Entity Type | Organization
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Legal Business Name | APT FOUNDATION, INC
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Dates
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Enumeration Date | 07/29/2014
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Last Update Date | 01/13/2017
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Provider Practice Location Address
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Address Line | 495 CONGRESS AVE
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City | NEW HAVEN
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State | CT
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Zip | 06519-1312
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Country | US
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Telephone | 203-781-4600
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Fax | 203-781-4624
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Provider Business Mailing Address
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Address Line | 1 LONG WHARF DR STE 321
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City | NEW HAVEN
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State | CT
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Zip | 06511-5991
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Country | US
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Telephone | 203-781-4600
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Fax | 203-781-4624
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Authorized Official
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Title or Position | PRESIDENT/CHIEF EXECUTIVE OFFICER
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Name | LYNN M MADDEN
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Credential | MPA
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Telephone | 203-781-4600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 0366
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License Number State | CT
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