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NPI Verification

National Provider Identifier: 1245410406

Internal Medicine Specialists

Organization

Primary Specialty

Internal Medicine

Code: 207R00000X

All Specialties (3)

Internal Medicine, Endocrinology, Diabetes & Metabolism

Code: 207RE0101X

Nurse Practitioner, Adult Health

Code: 363LA2200X

Internal Medicine

Code: 207R00000X

Primary

Practice Address

1389 WEST MAIN ST

STE 224

WATERBURY, CT 067080000

Phone: 203-597-0393

NPI Enumeration Date

November 5, 2007

NPI Number

1245410406

Data sourced from the official CMS NPPES Registry. This information is provided by the Centers for Medicare & Medicaid Services and is updated regularly.

View on CMS NPPES Registry