EDWARD MCDERMOTT, MD (NPI# 1629109467) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1629109467 |
| Entity Type | Organization |
| Organization Name | EDWARD MCDERMOTT, MD |
| Practice Address |
276r Montauk Ave New London CT 06320 |
| Practice Telephone | 8604471475 |
| Practice Fax Number | 8604478598 |
| Mailing Telephone | 8604471475 |
| Mailing Fax Number | 8604478598 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2008-11-17 |
| Authorized Official Name | EDWARD J MCDERMOTT (OWNER) |
| Authorized Official Telephone | 8604471475 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | 20822 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | HEALTH NET | 030963 | 01 |
| CT | 001208222 | 05 | |
| CT | ANTHEM BLUE CROSS | 010020822CT03 | 01 |
| CT | RAILROAD MEDICARE | DB1041 | 01 |
| Street Address |
276R MONTAUK AVE |
| City | NEW LONDON |
| State | CT |
| Zip Code | 06320 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942824891 | Shilpi Jain | Physical Therapist | 31 Vauxhall Street, Beechwood Post Accute, Transitional, New London, CT 06320 | 2020-06-05 |
| 1174009641 | Catherine Hinojosa | Nurse Practitioner | 1 Shaws Cove, New London, CT 06320 | 2018-07-17 |
| 1043668320 | Cultivate & Grow Inc. | Counselor | 302 State St Suite 307, New London, CT 06320 | 2016-05-27 |
| 1295137263 | Jacqueline Durnell | Registered Nurse | 15 Mohegan Drive, Us Coast Guard Academy Regional Clinic, New London, CT 06320 | 2014-09-22 |
| 1922427541 | Corina Vendetto | Registered Nurse | 245 Shaw St., New London, CT 06320 | 2014-04-10 |
| 1912329962 | Janelle Posey-green | Social Worker | 302 State St., Suite 201, New London, CT 06320 | 2014-01-10 |
| 1750622692 | Cynthia Mitchell | Social Worker | 65b Michael Rd, New London, CT 06320 | 2013-03-01 |
| 1518254507 | Simon J Shapiro | Physical Medicine & Rehabilitation | 190 Howard Avenue, New London, CT 06320 | 2011-06-29 |
| 1184876708 | Jane P Genido-trujillo | Nurse Practitioner | 270 Mohegan Ave., Student Health Services, New London, CT 06320 | 2008-10-14 |
| 1932356284 | Gerard Joseph Ventura | Dentist | 21 Montauk Ave., Suite 102, New London, CT 06320 | 2008-08-19 |
| Find all providers in zip 06320 | ||||
| Taxonomy Code | 207R00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750782728 | Shri Verma Md Gastroenterology LLC | Internal Medicine | 391 Ocean Ave, New London, CT 06320-4717 | 2014-09-10 |
| 1710075924 | Melvin A Yoselevsky | Internal Medicine | 334 Montauk Avenue, New London, CT 06320-4786 | 2006-10-11 |
| 1558465849 | William A Colom | Internal Medicine | 447 Montauk Avenue, New London, CT 06320 | 2006-09-08 |
| 1720182108 | Patricia Louise Cronin | Internal Medicine | 4 Shaws Cv Fl 1, New London, CT 06320-4956 | 2006-09-07 |
| 1093733875 | Suzanne J Klekotka | Internal Medicine | 155 Montauk Ave, New London, CT 06320-4842 | 2006-07-18 |
| 1811981830 | Marie T Weber | Internal Medicine | 1420 Algoma St, New London, WI 54961-2104 | 2005-09-06 |
| 1568460186 | Steven Lu | Internal Medicine | 365 Montauk Ave, Rm 4.512, New London, CT 06320-4700 | 2005-07-08 |
| 1831197565 | Craig R Buggeln | Internal Medicine | 419 Montauk Ave, New London, CT 06320-4621 | 2005-07-07 |
| 1407471246 | Lawrence and Memorial Hospital, Inc. | Internal Medicine | 365 Montauk Ave, New London, CT 06320-4700 | 2020-06-08 |
| 1659808962 | Yilu Qin | Internal Medicine | 365 Montauk Ave, New London, CT 06320-4700 | 2017-05-17 |
| Find all providers in NEW LONDON | ||||
| City | NEW LONDON |
| Zip Code | 06320 |
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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.