CARDIOMED OF CONNECTICUT LLC NPI 1699964403

NPI Information

NPI: 1699964403
Provider Name: CARDIOMED OF CONNECTICUT, LLC
Classification: Internal Medicine - 207RC0000X
Entity Type: Organization

Specialization: Cardiovascular Disease

Address:
4695 MAIN ST
SUITE 19
BRIDGEPORT, CT
ZIP 06606
Phone: (203) 371-5189
Get Directions

CARDIOMED OF CONNECTICUT, LLC is a cardiovascular disease internal medicine in Bridgeport, CT. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. CARDIOMED OF CONNECTICUT, LLC NPI is 1699964403. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

4695 MAIN ST
SUITE 19
BRIDGEPORT, CT
ZIP 06606-802
Phone: (203) 371-5189
Fax: (203) 372-6365

The provider's authorized official is Mohummad Raza .
The authorized official title is Owner and has the following contact phone number (203) 371-5189.

The enumeration date for this NPI number is 10/17/2007 and was last updated on 5/8/2014.

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
1	207RC0000X	Internal Medicine	Cardiovascular Disease	036793	CONNECTICUT	Yes

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
1	C02366	MEDICARE UPIN	CONNECTICUT
2	001367938	MEDICAID	CONNECTICUT

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

NPI Synchronization or Removal

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