Individual provider Active NPI

Laurie A Haydu, RN

  • Nurse Practitioner
  • Bridgeport, CT
National Provider Identifier
1407876543
Registry record updated Mar 29, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
363L00000X Issued in CT
Practice address
211 State St
Bridgeport, CT 06604-4808
Phone
(203) 394-6785
Fax
(203) 394-6784
NPI assigned
Jul 20, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 363L00000X CT Primary

Addresses

Primary practice location

211 State St
Bridgeport, CT 06604-4808

Mailing address

345 Whitney Ave
New Haven, CT 06511-2348
Phone (203) 752-2856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050525000047 CT Practitioner - Nurse Practitioner 3678515137 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
363L00000XCTMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Planned Parenthood of Southern New England, Inc. CurrentSince Oct 1, 2003 Accepting new patients

Locations

211 State St
Bridgeport, CT 06604
Phone (203) 366-0664

345 Whitney Ave
New Haven, CT 06511
Phone (203) 503-0450

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": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332979200000",
    "number": "1407876543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 WHITNEY AVE",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065112348",
            "telephone_number": "203-752-2856"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 STATE ST",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066044808",
            "telephone_number": "203-394-6785",
            "fax_number": "203-394-6784"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAYDU",
        "first_name": "LAURIE",
        "middle_name": "A",
        "credential": "RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2012-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CT",
            "license": "363L00000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

Verify at the official NPI Registry.