COASTAL CONNECTICUT MEDICAL GROUP PLLC (NPI# 1659859080) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1659859080 |
| Entity Type | Organization |
| Organization Name | COASTAL CONNECTICUT MEDICAL GROUP PLLC |
| Other Organization Name | COASTAL CONNECTICUT MEDICAL GROUP |
| Practice Address |
2900 Main St Bldg Suite1f Stratford CT 06614-4946 |
| Mailing Address |
1 E Putnam Ave Greenwich CT 06830-5429 |
| Practice Telephone | 2036586051 |
| Practice Fax Number | 2036586051 |
| Mailing Telephone | 2036586051 |
| Mailing Fax Number | 2036586051 |
| Enumeration Date | 2018-07-28 |
| Last Update Date | 2018-07-28 |
| Authorized Official Name | DR. STEVEN MURPHY (MANAGING PARTNER) |
| Authorized Official Telephone | 2036586051 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RA0201X |
Internal Medicine Specialization: Allergy & Immunology |
Allopathic & Osteopathic Physicians | ||
| N | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
Allopathic & Osteopathic Physicians | ||
| N | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians | ||
| N | 207ZC0006X |
Pathology Specialization: Clinical Pathology |
Allopathic & Osteopathic Physicians | ||
| N | 208000000X | Pediatrics | Allopathic & Osteopathic Physicians | ||
| N | 2085U0001X |
Radiology Specialization: Diagnostic Ultrasound |
Allopathic & Osteopathic Physicians | ||
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Coastal Connecticut Medical Group | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | COASTAL CONNECTICUT MEDICAL GROUP PLLC | 1 East Putnam Avenue, 1 East Putnam Avenue, Greenwich, CT 06830 |
| Street Address |
2900 MAIN ST BLDG SUITE1F |
| City | STRATFORD |
| State | CT |
| Zip Code | 06614-4946 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588139604 | David A Crosby | Physician Assistant | 125 Pumpkin Ground Road, Stratford, CT 06614 | 2018-10-04 |
| 1710489232 | Karen Marie Laconte | Naturopath | 720 Hilltop Dr, Stratford, CT 06614 | 2018-02-28 |
| 1972024693 | Amanda Wilson | Social Worker | 60 Edmund Street, Stratford, CT 06614 | 2017-07-03 |
| 1558801423 | Kristine Lynn Conlan | Physical Therapist | 55 Pasadena Ave., Stratford, CT 06614 | 2017-02-27 |
| 1811440258 | Seokwon Kwon | Dentist | 320 Boston Ave, Stratford, CT 06614 | 2016-08-02 |
| 1093176141 | Kathleen G Domek | Technician/Technologist | 150 Barnum Avenue Cut Off, Stratford, CT 06614 | 2016-03-17 |
| 1417328634 | Kelley Machado | Social Worker | 2127 Nichols Ave, Stratford, CT 06614 | 2015-10-14 |
| 1043629553 | Jennifer Woods-mesquita | Social Worker | 125 Greenlawn Ave, Stratford, CT 06614 | 2014-08-08 |
| 1437564010 | Jose R. Pacheco | Obstetrics & Gynecology | 120 Brightwood Ave, Stratford, CT 06614 | 2014-06-23 |
| 1740612829 | Stanley Brovender | General Practice | 773b Pontiac Lane, Stratford, CT 06614 | 2013-07-31 |
| Find all providers in zip 06614 | ||||
| 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 |
|---|---|---|---|---|
| 1265852974 | Magdala K. Chery | Internal Medicine | 42 E Laurel Rd # Udp3100, Stratford, NJ 08084-1354 | 2014-04-21 |
| 1770881153 | Internal Medicine of Dr.karkanitsa, LLC | Internal Medicine | 6580 Main St, Stratford, CT 06614-1605 | 2011-03-08 |
| 1417122946 | Charles Bruce-tagoe | Internal Medicine | 3272 Main St, Stratford, CT 06614-4819 | 2008-04-25 |
| 1760582134 | Kori K Krueger | Internal Medicine | 101 S Wisconsin Ave, Stratford, WI 54484-9692 | 2006-09-25 |
| 1669435087 | Leonid Karkanitsa | Internal Medicine | 6580 Main St Fl 1, Stratford, CT 06614 | 2006-04-07 |
| 1144289513 | John Kirkland | Internal Medicine | 3017 Main St, Stratford, CT 06614-4977 | 2006-03-22 |
| 1891775979 | Elizabeth Helfer | Internal Medicine | 42 E. Laurel Rd 3100, Stratford, NJ 08084-1354 | 2006-01-17 |
| 1477532802 | Jeffrey Friedman | Internal Medicine | 205 E Laurel Rd, 1st Floor, Stratford, NJ 08084-1301 | 2006-01-13 |
| 1194708800 | James Patrick Ralabate | Internal Medicine | 2890 Main St Ste 2a, Stratford, CT 06614-4980 | 2005-11-28 |
| 1093708067 | Donald R Noll | Internal Medicine | 42 E Laurel Rd, Udp #1800, Stratford, NJ 08084-1354 | 2005-08-25 |
| Find all providers in STRATFORD | ||||
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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.