Individual provider Active NPI

Raquel Stanko, RN

  • Addiction (Substance Use Disorder) Registered Nurse
  • New Haven, CT
National Provider Identifier
1346536372
Registry record updated Jun 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) Registered NurseTaxonomy code 163WA0400X
License
79119 Issued in CT
Practice address
232 Cedar St
New Haven, CT 06519-1610
Phone
(203) 503-3300
Fax
(203) 781-0276
NPI assigned
Jun 28, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Registered Nurse 163WA0400X 79119 CT Primary

Addresses

Primary practice location

232 Cedar St
New Haven, CT 06519-1610

Mailing address

913 State St
New Haven, CT 06511-3926
Phone (203) 503-3351

Other identifiers 2

IdentifierTypeStateIssuer
004235918MedicaidCT
004235900MedicaidCT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Cornell Scott Hill Health Corporation Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1309219200000",
    "number": "1346536372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 STATE ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065113926",
            "telephone_number": "203-503-3351",
            "fax_number": "203-781-0276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "232 CEDAR ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065191610",
            "telephone_number": "203-503-3300",
            "fax_number": "203-781-0276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STANKO",
        "first_name": "RAQUEL",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2011-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Addiction (Substance Use Disorder)",
            "state": "CT",
            "license": "79119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235918",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004235900",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2011; 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.