CT Center for Bladder Health LLC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

004196 Issued in CT

Legal business name

CT CENTER FOR BLADDER HEALTH LLC

Practice address

136 Hazard Ave BLDG 6
Enfield, CT 06082-4520

Phone

(860) 670-3039

NPI assigned

Jun 25, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Alison Joan Gorman, APRN

Title

Owner

Phone

(860) 670-3039

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1340582400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1343088000000",
    "number": "1174886188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 N MEADOW RD",
            "city": "WINDSOR",
            "state": "CT",
            "postal_code": "060952524",
            "telephone_number": "860-670-3039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 HAZARD AVE BLDG 6",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824520",
            "telephone_number": "860-670-3039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CT CENTER FOR BLADDER HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-25",
        "last_updated": "2012-07-24",
        "status": "A",
        "authorized_official_last_name": "GORMAN",
        "authorized_official_first_name": "ALISON",
        "authorized_official_middle_name": "JOAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-670-3039",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "CT",
            "license": "004196",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Enfield, CT
• Providers in Enfield, CT by specialty
• Family Nurse Practitioner in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.