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INTERNAL MEDICINE OF WEST HAVEN LLC NPI 1003005703


NPI Information

NPI: 1003005703
Provider Name: INTERNAL MEDICINE OF WEST HAVEN LLC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 07D1008034

Address:
764 CAMPBELL AVE
SUITE E
WEST HAVEN, CT
ZIP 06516
Phone: (203) 931-0034
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INTERNAL MEDICINE OF WEST HAVEN LLC is an internal medicine in West Haven, 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. INTERNAL MEDICINE OF WEST HAVEN LLC NPI is 1003005703. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

764 CAMPBELL AVE
SUITE E
WEST HAVEN, CT
ZIP 06516-786
Phone: (203) 931-0034
Fax: (203) 931-8225

The provider's authorized official is Piyush Gupta .
The authorized official title is Physician and has the following contact phone number (203) 931-0034.

The CLIA number assigned to this NPI record is 07D1008034 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/18/2007 and was last updated on 4/3/2024.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal MedicineYes
22084B0040XPsychiatry & NeurologyBehavioral Neurology & NeuropsychiatryNo

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 Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1001359844MEDICAIDCONNECTICUT
2008080626MEDICAIDCONNECTICUT

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: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.