CONNECTICUT PLASTIC SURGERY GROUP, LLC (NPI# 1689812885) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689812885 |
| Entity Type | Organization |
| Organization Name | CONNECTICUT PLASTIC SURGERY GROUP, LLC |
| Practice Address |
2600 Post Rd Southport CT 06890-1258 |
| Practice Telephone | 2032928119 |
| Practice Fax Number | 2032928120 |
| Mailing Telephone | 2032928119 |
| Mailing Fax Number | 2032928120 |
| Enumeration Date | 2009-01-26 |
| Last Update Date | 2009-10-26 |
| Authorized Official Name | DR. TITO L. VASQUEZ (PHYSICIAN/MANAGER) |
| Authorized Official Telephone | 2032928119 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2086S0105X |
Surgery Specialization: Surgery of the Hand |
046169 | CT | Allopathic & Osteopathic Physicians |
| Y | 2086S0122X |
Surgery Specialization: Plastic and Reconstructive Surgery |
046169 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
2600 POST RD |
| City | SOUTHPORT |
| State | CT |
| Zip Code | 06890-1258 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871573329 | Robert W Kipp Jr. | Chiropractor | 2600 Post Rd, Suite L2, Southport, CT 06890-1258 | 2006-01-20 |
| 1861046948 | Jason J Grygier | Optometrist | 2600 Post Rd, Ste 210, Southport, CT 06890-3206 | 2019-07-28 |
| 1689160145 | Aaron Nichols | Optometrist | 2600 Post Rd, Southport, CT 06890 | 2018-07-09 |
| 1801228598 | Breanna Lyn Razdan | Chiropractor | 2600 Post Rd, Southport, CT 06890-1258 | 2013-08-05 |
| 1710224415 | Eyecare Associates LLC | Optometrist | 2600 Post Rd, Southport, CT 06890-1258 | 2013-01-15 |
| 1487981395 | Michael Joseph Reynolds | Dentist | 2600 Post Rd, Southport, CT 06890-1258 | 2009-11-13 |
| 1083889398 | Tito L. Vasquez | Plastic Surgery | 2600 Post Rd, Southport, CT 06890-1258 | 2008-04-28 |
| 1174715460 | Eye Care Associatel of Fairfield PC | Optometrist | 2600 Post Rd, Southport, CT 06890-1258 | 2007-08-10 |
| 1548487259 | Judy L Boslow | Obstetrics & Gynecology | 2600 Post Rd, Suite Suite 1l, Southport, CT 06890-1258 | 2007-04-20 |
| 1982734885 | Pro-health Chiropractic, P.C. | Chiropractor | 2600 Post Rd, Suite L2, Southport, CT 06890-1258 | 2007-03-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821500703 | Abby Hill Smith | Audiologist | 2600 Post Rd Ste 2, Southport, CT 06890 | 2017-10-31 |
| 1255879748 | Northeast Breast Reconstruction LLC | Surgery | 21 Southport Terrace, Southport, CT 06890 | 2017-02-06 |
| 1487108908 | Discovery Practice Management, Inc. | Psychiatric Residential Treatment Facility | 3530 Post Rd Ste 306, Southport, CT 06890 | 2016-08-12 |
| 1023469343 | Alexandra Kosma | Behavioral Analyst | 1080 Mill Hill Ter, Southport, CT 06890 | 2016-06-28 |
| 1801126552 | Sabita Kanhai | Massage Therapist | 3519 Post Road, Southport, CT 06890 | 2009-12-31 |
| 1083689962 | Ben Duncan Ramaley | Specialist | 2600 Post Road, Suite 1l, Southport, CT 06890 | 2006-02-22 |
| 1346594116 | Sharon Renee Mccormick | Marriage & Family Therapist | 49 John Street, New Learning Therapy Center, Southport, CT 06890 | 2012-11-01 |
| 1841558897 | Olga Marsillio | Nurse Anesthetist, Certified Registered | Norwalk Hospital, 34 Maple Street, Norwalk, CT 06890 | 2012-04-27 |
| 1033215256 | Bradford Stephen Chervin | Otolaryngology | 2600 Post Road, Southport, CT 06890 | 2006-09-15 |
| 1396074365 | Louis Matis | Specialist | 775 Flintlock Rd, Southport, CT 06890-1066 | 2009-12-21 |
| Find all providers in zip 06890 | ||||
| Taxonomy Code | 2086S0122X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Surgery |
| Specialization | Plastic and Reconstructive Surgery |
| A surgeon who specializes in plastic and reconstructive surgery. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A General Certificate is issued by the American Osteopathic Board of Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255879748 | Northeast Breast Reconstruction LLC | Surgery | 21 Southport Terrace, Southport, CT 06890 | 2017-02-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932586682 | Northeast Plastic Surgery Center LLC | Surgery | 5-1 Davis Road West, Suite 3, Old Lyme, CT 06371 | 2015-05-01 |
| 1205168499 | Vinod V Pathy Md LLC | Surgery | 1525 Boston Post Rd, Westbrook, CT 06498-2044 | 2010-02-12 |
| 1568609121 | Stacey Lauren June | Surgery | 107 Newtown Road Suite 2c, Danbury, CT 06810 | 2009-01-19 |
| 1982861860 | Mark Manuel Melendez | Surgery | 4 Corporate Dr Ste 288, Shelton, CT 06484-6240 | 2008-05-19 |
| 1275602146 | Andrew Nelson Kornstein | Surgery | 539 Danbury Rd, Wilton, CT 06897-2216 | 2006-11-07 |
| 1831287275 | Sergio D. Francescon | Surgery | 540 S. Broad Street, Suite 3c, Meriden, CT 06450-6600 | 2006-10-11 |
| 1578583282 | Stephan Ariyan | Surgery | 60 Temple St Ste 7c, New Haven, CT 06510-2716 | 2006-07-19 |
| 1093795387 | Colleen J Jambor | Surgery | 33 Dale Road, Ste 1, Avon, CT 06001 | 2006-01-20 |
| 1053303818 | John F Reilly | Surgery | 2 Ivy Brook Rd, Suite 105, Shelton, CT 06484-6416 | 2005-08-18 |
| 1922515006 | The Plastic and Reconstructive Surgery Group, PC | Surgery | 2 Greenwich Office Park Ste 210, Greenwich, CT 06831-5155 | 2018-01-10 |
| 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.