Provider Demographics
NPI:1427343441
Name:MAPIRIPANA-YURUPARI OF NEW ENGLAND, INC.
Entity type:Organization
Organization Name:MAPIRIPANA-YURUPARI OF NEW ENGLAND, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAURICIO
Authorized Official - Middle Name:
Authorized Official - Last Name:ROMERO-GONZALEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD, MPH
Authorized Official - Phone:203-606-9636
Mailing Address - Street 1:1165 FOREST ROAD
Mailing Address - Street 2:SUITE B
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-2443
Mailing Address - Country:US
Mailing Address - Phone:203-691-9611
Mailing Address - Fax:
Practice Address - Street 1:1165 FOREST RD
Practice Address - Street 2:SUITE B
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06515-2443
Practice Address - Country:US
Practice Address - Phone:203-691-9611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-17
Last Update Date:2011-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM1000XAmbulatory Health Care FacilitiesClinic/CenterMigrant Health