Provider Demographics
NPI:1487889655
Name:APT FOUNDATION INC
Entity type:Organization
Organization Name:APT FOUNDATION INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:M
Authorized Official - Last Name:MADDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MPA
Authorized Official - Phone:203-781-4600
Mailing Address - Street 1:1 LONG WHARF DR
Mailing Address - Street 2:SUITE 321
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-5991
Mailing Address - Country:US
Mailing Address - Phone:203-781-4600
Mailing Address - Fax:203-781-4624
Practice Address - Street 1:1 LONG WHARF DR
Practice Address - Street 2:SUITE 10
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5991
Practice Address - Country:US
Practice Address - Phone:203-781-4357
Practice Address - Fax:203-781-4705
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-18
Last Update Date:2017-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTSA-0190261QM2800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2800XAmbulatory Health Care FacilitiesClinic/CenterMethadone
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001302497OtherSHI MEDICAID
CT008003745OtherASCESS/MEDCAID/MMT
CT008038040OtherLENCZYCKI MEDICAID
CT008063396OtherMEMISEVICH MEDICAID
CT001340132OtherSAVAGE MEDICAID
CT008057039OtherMILLER MEDICAID
CT008057135OtherMEDICAID HEATHER KNOX
CT008058728OtherRIERA TIMOTHY MEDICAID
CT001155787OtherSHIMELMAN MEDICAID
CT008037391OtherSHACKELL MEDICAID
CT008038036OtherBAKER MEDICAID
CT008048372OtherSHARMAIN MEDICAID
CT001307439OtherALTICE MEDICAID
CT001423136OtherTETRAULT MEDICAID
CT008001077OtherMOORE MEDICAID
CT008038042OtherPOLANETSKA MEDICAID
CT001218107OtherSCHOTTENFELD MEDICAID
CT008053091OtherBUTNER MEDICAID
CT008058058OtherSADINSKY MEDICAID
CO008009745OtherDESROSIERS MEDCAID
CT008038044OtherFARNUM MEDICAID
CT008039605OtherHERMES MEDICAID #
CT008042701OtherKATZMAN MEDICAID
CT008048393OtherBARRY MEDICAID
CT008048733OtherSUCHMAN MEDICAID
CT008063217OtherAPPLEGET MEDICAID
CT008066801OtherHAQUE MEDICAID
CT008069118OtherCAMPBELL MEDICAID #
CT008038043OtherWHELAN MEDICAID
CT008038741OtherOWEN MEDICAID
CT008040283OtherCAMENGA MEDICAID
CT008064860OtherWEISS MEDICAID
CT008071202OtherMEDICAID AMYNAH DHARANI
CT001155787OtherSHIMELMAN MEDICAID
CT008053091OtherBUTNER MEDICAID
CO008009745OtherDESROSIERS MEDCAID
CT008057135OtherMEDICAID HEATHER KNOX
CT008048393OtherBARRY MEDICAID
CT001302497OtherSHI MEDICAID
CTG06184Medicare UPIN
CTD400357474Medicare PIN
CT440000058Medicare PIN
CTD400365390Medicare PIN
CT001218107OtherSCHOTTENFELD MEDICAID
CT008057039OtherMILLER MEDICAID
CT008037391OtherSHACKELL MEDICAID
CT008038042OtherPOLANETSKA MEDICAID
CT008038043OtherWHELAN MEDICAID
CTD400132157Medicare PIN
CTD400083844Medicare PIN