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EASTERN CONNECTICUT MEDICAL PROFESSIONALS FOUNDATION INC NPI 1770557712


NPI Information

NPI: 1770557712
Provider Name: EASTERN CONNECTICUT MEDICAL PROFESSIONALS FOUNDATION INC

Doing Business As: EASTERN CT MEDICAL PROFESSIONALS

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 07D0984324

Address:
71 HAYNES ST
MILLER BLDG, FLOOR G
MANCHESTER, CT
ZIP 06040
Phone: (860) 533-2981
Get Directions

EASTERN CONNECTICUT MEDICAL PROFESSIONALS FOUNDATION INC is a family medicine in Manchester, CT. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. EASTERN CONNECTICUT MEDICAL PROFESSIONALS FOUNDATION INC NPI is 1770557712. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Eastern Ct Medical Professionals.

The provider's business location address is:

71 HAYNES ST
MILLER BLDG, FLOOR G
MANCHESTER, CT
ZIP 06040-131
Phone: (860) 533-2981
Fax: (860) 533-2975

The provider's authorized official is Peter J Karl .
The authorized official title is President & Ceo and has the following contact phone number (860) 646-1222.

The CLIA number assigned to this NPI record is 07D0984324 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/15/2006 and was last updated on 10/3/2013.


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
1207X00000XOrthopaedic SurgeryNo
22086S0129XSurgeryVascular SurgeryNo
3208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)No
4101YP2500XCounselorProfessionalCONNECTICUTNo
5106H00000XMarriage & Family TherapistCONNECTICUTNo
6207R00000XInternal MedicineNo
7207RE0101XInternal MedicineEndocrinology, Diabetes & MetabolismNo
8207RG0100XInternal MedicineGastroenterologyNo
9208600000XSurgeryNo
10208M00000XHospitalistNo
11363AM0700XPhysician AssistantMedicalNo
12363L00000XNurse PractitionerNo
13207VX0201XObstetrics & GynecologyGynecologic OncologyNo
141041C0700XSocial WorkerClinicalCONNECTICUTNo
15207Q00000XFamily MedicineYes

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
1004271285MEDICAIDCONNECTICUT
201003917CT05OTHERCONNECTICUTANTHEM ID - ALI HEMACHA, MD
3004268571MEDICAIDCONNECTICUT
4004271300MEDICAIDCONNECTICUT
5C01875MEDICARE PINCONNECTICUT
6004181351MEDICAIDCONNECTICUT
7004268620MEDICAIDCONNECTICUT
8004212750MEDICAIDCONNECTICUT

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: 11/14/2023

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.