Southern Connecticut Geriatric & Preventive Medicine LLC
Internal Medicine, Geriatric Medicine in New Haven, Connecticut
1679701882- Practice location
- 390 Livingston St, New Haven, CT 06511-1336
- Phone
- 203-871-9224
- Fax
- —
- Last updated
- October 4, 2021
Southern Connecticut Geriatric & Preventive Medicine LLC is a healthcare organization based in New Haven, CT. Southern Connecticut Geriatric & Preventive Medicine LLC practices in New Haven, CT. The NPI Number for Southern Connecticut Geriatric & Preventive Medicine LLC is 1679701882 and holds a License No. 041288 (CT). The current practice location address for Southern Connecticut Geriatric & Preventive Medicine LLC is 390 Livingston St, New Haven, CT 06511-1336 and can be reached out via phone at 203-871-9224.
Provider Profile Details
- NPI Number
- 1679701882
- Provider Name
- Southern Connecticut Geriatric & Preventive Medicine LLC
- Provider Entity Type
- Organization
- Address
- 390 Livingston St, New Haven, CT 06511-1336
- Phone Number
- 203-871-9224
- Primary Taxonomy
- Internal Medicine, Geriatric Medicine · 207RG0300X
- Organization Subpart
- No
- Authorized Official
- Dr. Asefeh Heiat, MD, MPH · Member · 203-871-9224
- Provider Enumeration Date
- June 25, 2009
- Last Update Date
- October 4, 2021
- Certification Date
- October 4, 2021
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 390 Livingston St
New Haven, CT 06511-1336 - City
- New Haven
- State
- Connecticut
- Zip
- 06511-1336
- Phone Number
- 203-871-9224
Provider Business Mailing Address Details
- Address
- 390 Livingston St
New Haven, CT 06511-1336 - City
- New Haven
- State
- CT
- Zip
- 06511-1336
- Phone Number
- 203-871-9224
License Information
- License Number (1)
- 041288
- License State (1)
- CT
- Taxonomy (1)
- Preventive Medicine, Public Health & General Preventive Medicine · 2083P0901X
- Taxonomy (2)
- Internal Medicine, Geriatric Medicine · 207RG0300X
- License Number (3)
- 041288
- License State (3)
- CT
- Taxonomy (3)
- Internal Medicine, Geriatric Medicine · 207RG0300X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Southern Connecticut Geriatric & Preventive Medicine LLC?
The NPI number of Southern Connecticut Geriatric & Preventive Medicine LLC is 1679701882. It was assigned on June 25, 2009 and is currently active in the NPPES registry.
What is the specialty of Southern Connecticut Geriatric & Preventive Medicine LLC?
Southern Connecticut Geriatric & Preventive Medicine LLC is registered under the primary taxonomy Internal Medicine, Geriatric Medicine (code 207RG0300X), licensed in CT under license number 041288.
Where does Southern Connecticut Geriatric & Preventive Medicine LLC practice?
The practice location is 390 Livingston St, New Haven, CT 06511-1336. The office can be reached at 203-871-9224 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1679701882 directly on the NPPES registry website.