The Waterbury Young Men'S Christian Association

Primary specialty

Health EducatorTaxonomy code 174H00000X

Legal business name

THE WATERBURY YOUNG MEN'S CHRISTIAN ASSOCIATION

Practice address

136 W Main St
Waterbury, CT 06702-2005

Phone

(203) 754-9622

Fax

(203) 754-9095

NPI assigned

Oct 9, 2017

Organization subpart

No

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

Authorized official

Name

Mr. James O'Rourke

Title

Chief Executive Officer

Phone

(203) 754-9622

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1507507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1507507200000",
    "number": "1831609577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 W MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022005",
            "telephone_number": "203-754-9622",
            "fax_number": "203-754-9095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 W MAIN ST",
            "city": "WATERBURY",
            "state": "CT",
            "postal_code": "067022005",
            "telephone_number": "203-754-9622",
            "fax_number": "203-754-9095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WATERBURY YOUNG MEN'S CHRISTIAN ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-10-09",
        "last_updated": "2017-10-09",
        "status": "A",
        "authorized_official_last_name": "O'ROURKE",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "203-754-9622",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2017; 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.