DR. EDWARD HALSTEAD (NPI# 1316967649) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1316967649 |
| Entity Type | Individual |
| Full Name | DR. EDWARD HALSTEAD |
| Credential | M.D. |
| Practice Address |
130 Division St Derby CT 06418-1326 |
| Practice Telephone | 2037327403 |
| Practice Fax Number | 2037327177 |
| Mailing Telephone | 2037327403 |
| Mailing Fax Number | 2037327177 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
019479 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
130 DIVISION ST |
| City | DERBY |
| State | CT |
| Zip Code | 06418-1326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427058478 | Mihaela Boran | Psychiatry & Neurology | 130 Division St, Derby, CT 06418-1326 | 2005-07-29 |
| 1437767134 | Sovit Dahal | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-07-20 |
| 1649894056 | Julie Sim | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-06-01 |
| 1073133435 | Angad Singh Gill | Student in an Organized Health Care Education/Training Program | 130 Division St, Griffin Hospital, Derby, CT 06418 | 2020-04-25 |
| 1699394924 | Ricardo Adolfo Concepcion Gomez | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418 | 2020-04-16 |
| 1104455112 | Maharshi Panchal | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-04-02 |
| 1104455252 | Anwesh Babu Poosala | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-04-01 |
| 1720615271 | Anthony Karam Awad | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-03-25 |
| 1134756760 | Douglas Misael Palacios Hernandez | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-03-24 |
| 1437786142 | Rosa Constantino | Student in an Organized Health Care Education/Training Program | 130 Division St, Derby, CT 06418-1326 | 2020-03-24 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942839105 | Fnu Prinkiya | Student in an Organized Health Care Education/Training Program | Griffin Hospital. 130 Division St, Derby, CT 06418 | 2020-04-08 |
| 1942837935 | Ivanshi A Gondalia | Student in an Organized Health Care Education/Training Program | Griffin Hospital, 130 Division St, Derby, CT 06418 | 2020-03-27 |
| 1972168094 | Pir Saad | Student in an Organized Health Care Education/Training Program | C/o Margie Bliga, Department of Medical Education, Griffin Hospital, 130 Division St, Derby, CT 06418 | 2019-05-03 |
| 1295398899 | Ahtsham Yousaf Chaudhary | Student in an Organized Health Care Education/Training Program | 130 Division St, Griffin Hospital, Derby, CT 06418 | 2019-04-18 |
| 1477016376 | Rabia Usman | Student in an Organized Health Care Education/Training Program | 130 Division St. Griffin Hospital, Derby, CT 06418 | 2019-04-09 |
| 1932661428 | Meshal Qaiser | Student in an Organized Health Care Education/Training Program | 130 Division Street Griffin Hospital, Derby, CT 06418 | 2019-04-03 |
| 1275027666 | Victoria Anne Hodge Enquist | Social Worker | 241 Seymour Avenue, Griffin Hospital Iop, Seymour, CT 06418 | 2018-06-19 |
| 1811485758 | Nimeshayan Varatharajah | Student in an Organized Health Care Education/Training Program | Griffin Hospital, 130 Division St., Derby, CT 06418 | 2018-04-26 |
| 1851889836 | Pete Prashamsa Shenoy | Student in an Organized Health Care Education/Training Program | Griffin Hospital (dpt of Graduate Medical Education), 130 Division St., Derby, CT 06418 | 2018-04-25 |
| 1639696594 | Samantha Leigh Bassett | Counselor | 90 Sodom Lane, Derby, CT 06418 | 2017-08-23 |
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| Taxonomy Code | 2084A0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Medicine |
| A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |
| Notes: Source: American Osteopathic Board of Neurology and Psychiatry, 2007 [1/1/2008: definition added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366958480 | Mansfield Mental Health & Addiction Medicine | Psychiatry & Neurology | 18-e Ledgebrook Drive, 18-e, Mansfield Ctr, CT 06250 | 2017-12-27 |
| 1114462751 | Alma Rosa Barreto | Psychiatry & Neurology | 65 Avonwood Rd, Apt C9, Avon, CT 06001-2051 | 2017-01-05 |
| 1235339219 | Teo-carlo Straun | Psychiatry & Neurology | 279 New Britain Rd Ste A, Berlin, CT 06037-3165 | 2007-07-19 |
| 1053438267 | George Davis Gammon | Psychiatry & Neurology | 33 Edgehill Ter, Hamden, CT 06517-4017 | 2007-03-23 |
| 1316008360 | John P Ewing | Psychiatry & Neurology | 8 Titus Rd, Washington Depot, CT 06794-1517 | 2006-12-13 |
| 1093808727 | Elbert Greer Richardson Jr. | Psychiatry & Neurology | 234 Church St Ste 301, New Haven, CT 06510-1807 | 2006-10-02 |
| 1306937859 | Isabel S Rathbone | Psychiatry & Neurology | Va Connecticut/116a, 950 Campbell Avenue, West Haven, CT 06516 | 2006-09-28 |
| 1912463423 | Foenix Medical Consulting Pllc | Psychiatry & Neurology | 1 Turkey Hill Rd S Ste 100, Westport, CT 06880-5525 | 2019-02-20 |
| 1790091627 | Mona Thapa | Psychiatry & Neurology | 1 Long Wharf Dr, Ste 321, New Haven, CT 06511-5991 | 2010-08-30 |
| 1801094479 | Mahboob Ahmad Aslam | Psychiatry & Neurology | 546 Cromwell Ave, Suite 101, Rocky Hill, CT 06067-1800 | 2007-07-05 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.