Provider Demographics
NPI:1316295462
Name:STAMFORD HOSPITAL
Entity type:Organization
Organization Name:STAMFORD HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:APRN
Authorized Official - Prefix:MISS
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:FOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:APRN BC FNP
Authorized Official - Phone:203-803-9551
Mailing Address - Street 1:1340 WASHINGTON BLVD
Mailing Address - Street 2:APT 408
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901
Mailing Address - Country:US
Mailing Address - Phone:203-803-9551
Mailing Address - Fax:
Practice Address - Street 1:3 CEDARGATE LN
Practice Address - Street 2:
Practice Address - City:WESTPORT
Practice Address - State:CT
Practice Address - Zip Code:06880-3759
Practice Address - Country:US
Practice Address - Phone:203-803-9551
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-08-21
Last Update Date:2012-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5043282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital