MRS. MADELINE MANTILLA (NPI# 1184004335) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184004335 |
| Entity Type | Individual |
| Full Name | MRS. MADELINE MANTILLA |
| Credential | M.S. |
| Practice Address |
401 Shippan Ave Stamford CT 06902-6075 |
| Mailing Address |
180 Fairfield Ave Bridgeport CT 06604-4252 |
| Practice Telephone | 2035173375 |
| Practice Fax Number | 2033531524 |
| Mailing Telephone | 2033946529 |
| Mailing Fax Number | 2033848835 |
| Enumeration Date | 2015-06-03 |
| Last Update Date | 2019-12-03 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YP2500X |
Counselor Specialization: Professional |
003667 | CT | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 180 Fairfield Ave, Bridgeport, CT 066044252 | 2033946529 | 2033848835 |
| Street Address |
401 SHIPPAN AVE |
| City | STAMFORD |
| State | CT |
| Zip Code | 06902-6075 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861043242 | Palak Bhambri | Pharmacist | 537 Canal Street, Stamford, CT 06902 | 2019-09-26 |
| 1730654815 | Brenice Duroseau | Nurse Practitioner | 292 Long Ridge Rd Ste 202, Stamford, CT 06902 | 2018-10-04 |
| 1447732862 | Ngoc Lam | Pharmacist | 1990 West Main Street, Stamford, CT 06902 | 2018-09-01 |
| 1336627264 | Margaret F Gorelick | Nurse Practitioner | Stamford Health, One Hospital Plaza, Stamford, CT 06902 | 2018-08-02 |
| 1174053425 | Ashley Marie Santana | Social Worker | 110 Commons Park N Apt 1158, Stamford, CT 06902 | 2017-06-19 |
| 1578090395 | Anas Al-sabbagh | Dentist | 1 Strawberry Hill Court Suite L7 Stamford, Connecticut, Stamford, CT 06902 | 2017-05-11 |
| 1154862936 | Hillary Rubin | Psychologist | 44 Commerce Avenue, Stamford, CT 06902 | 2017-03-14 |
| 1801332135 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1 Hospital Plz Ste G122, Stamford, CT 06902 | 2017-01-10 |
| 1932563277 | Mary Hurtadodemendoza | Pharmacist | 59 Courtland Ave 2m, Stamford, CT 06902 | 2016-04-13 |
| 1235592247 | Advanced Therapy and Performance LLC | Physical Medicine & Rehabilitation | 75 Selleck Street, Stamford, CT 06902 | 2016-03-29 |
| Find all providers in zip 06902 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245889096 | Anna Diamantis | Counselor | 1200 High Ridge Road, 2nd Floor, Stamford, CT 06905 | 2019-09-04 |
| 1730746678 | Allison Denice Tables | Counselor | 1011 Hope St Fl 2, Stamford, CT 06907-2121 | 2019-05-27 |
| 1801305701 | Edward James Ruiz II | Counselor | 572 Roxbury Rd, Stamford, CT 06902-1131 | 2017-09-22 |
| 1023547593 | Amanda Brown | Counselor | 30 Buxton Farm Rd Ste 105, Stamford, CT 06905-1210 | 2017-06-08 |
| 1871941146 | Rebekah Kanefsky Lpc LLC | Counselor | 59 Rock Spring Rd, Unit 32, Stamford, CT 06906-1934 | 2016-05-27 |
| 1396090064 | Cynthia Wicker Williams | Counselor | 55 Ethan Allen Ln, Stamford, CT 06903-4027 | 2012-07-19 |
| 1346521606 | Maria Loretto Lacayo | Counselor | 124 Woodridge Dr S, Stamford, CT 06902-8334 | 2011-08-31 |
| 1013213362 | James J. Wisecup | Counselor | 53 W Bank Ln, Stamford, CT 06902-1309 | 2011-02-03 |
| 1003907403 | Sharon M Fornaciari | Counselor | 38 Hirsch Road, Stamford, CT 06905 | 2006-09-28 |
| 1023036183 | Susan K Cook | Counselor | 48 Don Bob Rd, Stamford, CT 06903-3003 | 2006-07-17 |
| Find all providers in STAMFORD | ||||
Please comment or provide details below to improve the information on MRS. MADELINE MANTILLA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.