| Positive Principles | |
|
1000 Lafayette Blvd Fl 11 Bridgeport CT 06604-4725 | |
| (203) 964-7941 | |
| Not Available |
| Full Name | Positive Principles |
|---|---|
| Speciality | Social Worker |
| Location | 1000 Lafayette Blvd Fl 11, Bridgeport, Connecticut |
| Authorized Official Name and Position | Irma I Santiago Moin (MEMBER) |
| Authorized Official Contact | 2039647941 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Positive Principles 1000 Lafayette Blvd Ste 1100 Bridgeport CT 06604-4710 Ph: (203) 964-7941 | Positive Principles 1000 Lafayette Blvd Fl 11 Bridgeport CT 06604-4725 Ph: (203) 964-7941 |
| NPI Number | 1477145993 |
|---|---|
| Provider Enumeration Date | 02/05/2021 |
| Last Update Date | 09/27/2024 |
| Certification Date | 09/27/2024 |
| Medicare PECOS PAC ID | 7113301789 |
|---|---|
| Medicare Enrollment ID | O20220831000569 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477145993 | NPI | - | NPPES |
| 008043652 | Medicaid | CT |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Irma I Santiago-moin |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699910844 PECOS PAC ID: 9537209796 Enrollment ID: I20091218000229 |
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