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SHORELINE MEDICAL ASSOCIATES LLC NPI 1497750798


NPI Information

NPI: 1497750798
Provider Name: SHORELINE MEDICAL ASSOCIATES LLC
Classification: Specialist - 174400000X
Entity Type: Organization
Address:
1353 BOSTON POST RD
MADISON, CT
ZIP 06443
Phone: (203) 245-4933
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SHORELINE MEDICAL ASSOCIATES LLC is a specialist in Madison, CT. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. SHORELINE MEDICAL ASSOCIATES LLC NPI is 1497750798. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1353 BOSTON POST RD
MADISON, CT
ZIP 06443-445
Phone: (203) 245-4933
Fax: (203) 245-4399

The provider's authorized official is Jennifer P Swenson .
The authorized official title is Physician and has the following contact phone number (203) 245-4933.

The enumeration date for this NPI number is 6/15/2005 and was last updated on 9/16/2015.


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
1363LF0000XNurse PractitionerFamily006159CONNECTICUTNo
2174400000XSpecialistYes

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
1I07599MEDICARE UPINCONNECTICUT
2970000409MEDICARE ID-TYPE UNSPECIFIEDCONNECTICUTJOSEPH SLATER MEDICARE #
3001378422MEDICAIDCONNECTICUT
4C07079MEDICARE UPINCONNECTICUT
5S55843MEDICARE UPINCONNECTICUT
6C02528MEDICARE PINCONNECTICUT
7001421916MEDICAIDCONNECTICUT
8G73163MEDICARE UPINCONNECTICUT
9001222280MEDICAIDCONNECTICUT
10P07788MEDICARE UPINCONNECTICUT
11080001338MEDICARE ID-TYPE UNSPECIFIEDCONNECTICUTJENNIFER SWENSON MEDICARE
12080001679MEDICARE ID-TYPE UNSPECIFIEDCONNECTICUTHELEN EDE MEDICARE #
13970000578MEDICARE ID-TYPE UNSPECIFIEDCONNECTICUTAIMEE CRISCUOLO MEDICARE

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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