CONNECTICUT MEDICAL GROUP, LLC (NPI# 1366504227) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366504227 |
| Entity Type | Organization |
| Organization Name | CONNECTICUT MEDICAL GROUP, LLC |
| Practice Address |
2989 Dixwell Ave Hamden CT 06518-3501 |
| Practice Telephone | 2032483013 |
| Practice Fax Number | 2032482878 |
| Mailing Telephone | 2032483013 |
| Mailing Fax Number | 2032482878 |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. RICHARD MANGI (PRESIDENT) |
| Authorized Official Telephone | 2032483013 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207KA0200X |
Allergy & Immunology Specialization: Allergy |
Allopathic & Osteopathic Physicians | ||
| X | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians | ||
| X | 207RA0201X |
Internal Medicine Specialization: Allergy & Immunology |
Allopathic & Osteopathic Physicians | ||
| X | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| X | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
Allopathic & Osteopathic Physicians | ||
| X | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
Allopathic & Osteopathic Physicians | ||
| X | 207RP1001X |
Internal Medicine Specialization: Pulmonary Disease |
Allopathic & Osteopathic Physicians | ||
| X | 207RR0500X |
Internal Medicine Specialization: Rheumatology |
Allopathic & Osteopathic Physicians | ||
| X | 363LP2300X |
Nurse Practitioner Specialization: Primary Care |
Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
2989 DIXWELL AVE |
| City | HAMDEN |
| State | CT |
| Zip Code | 06518-3501 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871082032 | Lynne Severance | Registered Nurse | 121 Highland Ave, Hamden, CT 06518 | 2018-05-03 |
| 1912446782 | Associates In Medical & Cosmetic Dermatology, PC | Dermatology | 9 Washington Avenue, Hamden, CT 06518 | 2017-02-14 |
| 1700338738 | The Lasik Vision Institute LLC | Clinic/Center | 2313 Whitney Avenue, Suite 1b, Hamden, CT 06518 | 2016-10-25 |
| 1639441934 | Michael Tonkyu Kim | Dentist | 2880 Old Dixwell Ave., Hamden, CT 06518 | 2012-02-01 |
| 1174751598 | Yetsa Adebodunde Tuakli-wosornu | Physical Medicine & Rehabilitation | 2080 Whitney Ave Ste 280, Hamden, CT 06518 | 2009-06-24 |
| 1619112133 | Priority Healthcare, LLC | Home Health | 12213 Town Walk Drive, Hamden, CT 06518 | 2008-12-12 |
| 1306095864 | Uttampal Singh | Dentist | 2832 Whitney Avenue- Advanced Orthodontics LLC, Suite- A, Hamden, CT 06518 | 2008-09-09 |
| 1790942100 | Wellcare of Connecticut, Inc. | Health Maintenance Organization | 2319 Whitney Avenue, 6th Floor, Hamden, CT 06518 | 2008-05-22 |
| 1720295165 | Susan Norkus | Specialist/Technologist | 275 Mt. Carmel Ave., Quinnipiac University, Hamden, CT 06518 | 2007-05-16 |
| 1447385620 | Fritz & Hawley Vision Center | Technician/Technologist | 2313 Whitney Ave, Suite 1d, Hamden, CT 06518 | 2007-02-21 |
| Find all providers in zip 06518 | ||||
| Taxonomy Code | 207KA0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Allergy & Immunology |
| Specialization | Allergy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225106867 | Kevin James Hunt | Allergy & Immunology | 2447 Whitney Ave, Hamden, CT 06518-3211 | 2006-12-01 |
| 1124131222 | Kevin J. Hunt, Md,pc | Allergy & Immunology | 2447 Whitney Ave, Hamden, CT 06518-3211 | 2006-08-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447676127 | Robert Louis Debernardo Sr. | Allergy & Immunology | 15 Essex Ln, Trumbull, CT 06611-1005 | 2014-03-05 |
| 1073717351 | Northwest Allergy, P.C. | Allergy & Immunology | 72a Park Lane Rd, New Milford, CT 06776-2325 | 2007-06-12 |
| 1467537290 | Starling Physicians, PC | Allergy & Immunology | 2110 Silas Deane Hwy, Rocky Hill, CT 06067-2313 | 2006-10-27 |
| 1881785673 | Mitchell Ross Lester | Allergy & Immunology | 148 E Avenue, Ste 3g, Norwalk, CT 06851 | 2006-09-27 |
| 1871523936 | Bruce E Englander | Allergy & Immunology | 160 Farmington Ave, Bristol, CT 06010-4218 | 2006-07-04 |
| 1578530507 | Pamela Laurie Kwittken | Allergy & Immunology | 40 Commerce Park, Milford, CT 06460-3535 | 2006-03-08 |
| 1316924749 | Doron J Ber | Allergy & Immunology | 23 Clara Dr, Suite 204, Mystic, CT 06355-1959 | 2005-12-28 |
| 1437142551 | Christopher Cronin Randolph | Allergy & Immunology | 1389 W Main St, Suite 205, Waterbury, CT 06708-3104 | 2005-08-24 |
| 1558367698 | Romana Primus | Allergy & Immunology | 1 Shaws Cv, New London, CT 06320-4902 | 2005-06-23 |
| 1285630798 | William James Rockwell | Allergy & Immunology | 4675 Main St, Bridgeport, CT 06606-1813 | 2005-06-21 |
| Find all providers with the same taxonomy | ||||
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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.