Town of Stratford

Primary specialty

Community Health Clinic/CenterTaxonomy code 261QC1500X

Legal business name

TOWN OF STRATFORD

Doing business as

STRATFORD HEALTH DEPARTMENT

Practice address

468 Birdseye St
3Rd Floor
Stratford, CT 06615-6976

Phone

(203) 385-4090

Fax

(203) 381-2048

NPI assigned

May 21, 2007

Organization subpart

No

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

Authorized official

Name

Ms. Andrea Boissevain, MPH

Title

Health Director

Phone

(203) 385-4090

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• STRATFORD HEALTH DEPARTMENT Doing business as

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Town of Stratford, Connecticut

  • Land Ambulance
  • Stratford, CT
  • NPI 1508854928

  2062316318

  Same PAC ID

Tax ID family

Stratford Health Depart5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

• Stratford Community Services

  • Marriage & Family Therapist
  • Stratford, CT
  • NPI 1851695837
  NPD tax ID
• Town of Stratford

  • Community/Behavioral Health Agency
  • Stratford, CT
  • NPI 1215386503
  NPD tax ID
• Town of Stratford Health Dept.

  • Student Health Clinic/Center
  • Stratford, CT
  • NPI 1114074606
  NPD tax ID
• Town of Stratford, Connecticut

  • Land Ambulance
  • Stratford, CT
  • NPI 1508854928
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Bernice Bova, RN

  • Community Health Registered Nurse
  • Stratford, CT
  • NPI 1013280023
  NPD (past)

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699401600000",
    "number": "1386853182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "468 BIRDSEYE ST",
            "address_2": "3RD FLOOR",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066156976",
            "telephone_number": "203-385-4090",
            "fax_number": "203-381-2048"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "468 BIRDSEYE ST",
            "address_2": "3RD FLOOR",
            "city": "STRATFORD",
            "state": "CT",
            "postal_code": "066156976",
            "telephone_number": "203-385-4090",
            "fax_number": "203-381-2048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOWN OF STRATFORD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2023-11-08",
        "certification_date": "2023-11-08",
        "status": "A",
        "authorized_official_last_name": "BOISSEVAIN",
        "authorized_official_first_name": "ANDREA",
        "authorized_official_title_or_position": "HEALTH DIRECTOR",
        "authorized_official_telephone_number": "203-385-4090",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MPH"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP0905X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Public Health, State or Local",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004062162",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "68VNA0021CT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "STRATFORD HEALTH DEPARTMENT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "STRATFORD HEALTH DEPARTMENT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kurt Joseph Tichy, O.D.
• Debra L Tomaselli, LMFT
• Kathleen Toombs, LMFT,DAPA
• Total Renal Care Inc
• Town of Stratford
• Town of Stratford Health Dept.
• Town of Stratford, Connecticut
• Catherine Tranquillo, M.S., BCBA, LBA
• Faysully Gloria Triana, OTR/L
• Phi Trinh

• Community Health Clinic/Center in Stratford, CT
• Providers in Stratford, CT by specialty
• Community Health Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.