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MEDICAL ONCOLOGY & HEMATOLOGY PC NPI 1073549648


NPI Information

NPI: 1073549648
Provider Name: MEDICAL ONCOLOGY & HEMATOLOGY, PC

Doing Business As: DIAGNOSTIC HEMATOLOGY LAB

Classification: Internal Medicine - 207RH0003X
Entity Type: Organization

Specialization: Hematology & Oncology

Address:
19 LUNAR DRIVE
WOODBRIDGE, CT
ZIP 06525
Phone: (203) 389-7504
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MEDICAL ONCOLOGY & HEMATOLOGY, PC is a hematology and oncology internal medicine in Woodbridge, CT. The provider is an internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. MEDICAL ONCOLOGY & HEMATOLOGY, PC NPI is 1073549648. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Diagnostic Hematology Lab.

The provider's business location address is:

19 LUNAR DRIVE
WOODBRIDGE, CT
ZIP 06525
Phone: (203) 389-7504
Fax: (203) 389-1666

The provider's authorized official is Sandra Coppola .
The authorized official title is Business Manager and has the following contact phone number (203) 389-7504.

The enumeration date for this NPI number is 6/24/2006 and was last updated on 10/11/2011.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207RH0003XInternal MedicineHematology & OncologyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1004001459MEDICAIDCONNECTICUT
2CM1770MEDICARE PIN
3690003007MEDICARE PIN
4C00657MEDICARE ID-TYPE UNSPECIFIED

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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