INTERNAL MEDICINE GROUP LLC NPI 1770617367

NPI Information

  • NPI: 1770617367
  • Provider Name: INTERNAL MEDICINE GROUP LLC
  • Classification: Internal Medicine - 207RG0300X
  • Specialization: Geriatric Medicine
  • Entity Type: Organization
  • CLIA Number: 07D0989083
  • Address: 1 TOWNE PARK PLZ
    NORWICH, CT
    ZIP 06360
  • Phone: (860) 887-0010

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NPI Details

INTERNAL MEDICINE GROUP LLC is a geriatric medicine internal medicine in Norwich, CT. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. INTERNAL MEDICINE GROUP LLC NPI is 1770617367. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1 TOWNE PARK PLZ
NORWICH, CT
ZIP 06360-247
Phone: (860) 887-0010
Fax: (860) 887-0178

The provider's authorized official is Hanna Kackielo .
The authorized official title is Owner and has the following contact phone number (860) 887-0010.

The CLIA number assigned to this NPI record is 07D0989083 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/15/2007 and was last updated on 8/22/2020.

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
1207RG0300XInternal MedicineGeriatric Medicine037461CONNECTICUTYes

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: 11/21/2025

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