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GERIATRIC PROFESSIONAL GROUP LLC NPI 1932295953


NPI Information

NPI: 1932295953
Provider Name: GERIATRIC PROFESSIONAL GROUP, LLC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization
Address:
4200 PARK AVE
BRIDGEPORT, CT
ZIP 06604
Phone: (203) 365-6473
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GERIATRIC PROFESSIONAL GROUP, LLC is an internal medicine in Bridgeport, CT. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. GERIATRIC PROFESSIONAL GROUP, LLC NPI is 1932295953. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4200 PARK AVE
BRIDGEPORT, CT
ZIP 06604-049
Phone: (203) 365-6473
Fax: (203) 396-1039

The provider's authorized official is Andrew H Banoff .
The authorized official title is President/ceo and has the following contact phone number (203) 365-6400.

The enumeration date for this NPI number is 10/5/2006 and was last updated on 11/7/2016.


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
1207R00000XInternal MedicineNo
2207R00000XInternal MedicineCONNECTICUTYes

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
19233MEDICAIDCONNECTICUT
2C02995MEDICARE UPINCONNECTICUT

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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