RICHARD NICHOLAS FORMICA (NPI# 1730163502) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730163502 |
| Entity Type | Individual |
| Full Name | RICHARD NICHOLAS FORMICA |
| Credential | MD |
| Practice Address |
800 Howard Ave Yale Physicians Building New Haven CT 06519 |
| Mailing Address |
Po Box 9805 300 George St 6th Floor New Haven CT 06536-0805 |
| Practice Telephone | 2037852140 |
| Practice Fax Number | 2037856414 |
| Mailing Telephone | 2037857998 |
| Mailing Fax Number | 2037856414 |
| Enumeration Date | 2005-12-05 |
| Last Update Date | 2012-03-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
036848 | CT | Allopathic & Osteopathic Physicians |
| N | 208M00000X | Hospitalist | 036848 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 001368481 | 05 |
| Street Address |
800 HOWARD AVE YALE PHYSICIANS BUILDING |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06519 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184621419 | John P Fulkerson | Orthopaedic Surgery | 800 Howard Ave, New Haven, CT 06519-1369 | 2005-07-01 |
| 1467068163 | Catherine Aileen Chagnon | Physical Medicine & Rehabilitation | 800 Howard Ave, New Haven, CT 06519-1369 | 2020-09-17 |
| 1508408915 | Rebecca Lynne Tallarita | Nurse Practitioner | 800 Howard Ave, New Haven, CT 06519 | 2019-10-17 |
| 1598323610 | Brianne Krawczyk | Pharmacist | 800 Howard Ave, Hvc Center-2nd Floor, New Haven, CT 06519 | 2019-06-04 |
| 1467017277 | Gabriel B Lerner | Student in an Organized Health Care Education/Training Program | 800 Howard Ave, New Haven, CT 06519-1369 | 2019-05-07 |
| 1467915413 | Sarah Elizabeth Savoia | Physician Assistant | 800 Howard Ave, New Haven, CT 06519-1369 | 2019-04-08 |
| 1992287577 | Brittany Cyr | Pharmacist | 800 Howard Ave, New Haven, CT 06519-1369 | 2018-08-30 |
| 1700395506 | Lauren Katherine Fagan | Audiologist | 800 Howard Ave, New Haven, CT 06519-1369 | 2017-09-25 |
| 1548784093 | Megan Frank Harari | Nurse Practitioner | 800 Howard Ave, Ste 1st Floor, Room 133, New Haven, CT 06519 | 2017-07-26 |
| 1942723168 | Jamie B Freeman | Physician Assistant | 800 Howard Ave, Yale Neurosurgery, New Haven, CT 06519-1369 | 2017-07-19 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255819348 | Jordan Ficocelli | Nurse Practitioner | 800 Howard Ave # 2, New Haven, CT 06519 | 2018-08-01 |
| 1780123414 | Claire Louise Hardin | General Acute Care Hospital | 95 Howard Ave, New Haven, CT 06519 | 2017-02-14 |
| 1467809137 | Ana Laura Vives-rodriguez | Student in an Organized Health Care Education/Training Program | 800 Howard Avenue, Lower Level, Yale Physicians Building, New Haven, CT 06519 | 2016-05-23 |
| 1346607785 | Amanda Kayte Corcoran | Advanced Practice Midwife | 40 Prince St., Suite 207, New Haven, CT 06519 | 2016-01-15 |
| 1720491905 | Sara Harcharik Perkins | Dermatology | 2 Church St S Ste 305, New Haven, CT 06519 | 2014-06-05 |
| 1194136713 | Krishan Ratilal Jethwa | Radiology | 35 Park St Ste Ll507, New Haven, CT 06519 | 2014-05-16 |
| 1235549353 | Brandon Michael Kitay | Psychiatry & Neurology | 184 Liberty St # Lv108, New Haven, CT 06519 | 2014-04-28 |
| 1649526617 | Yale New Haven Hospital | Student in an Organized Health Care Education/Training Program | 330 Cedar St Fmb 107, Yale New Haven Hospital, Dept of Surgery, New Haven, CT 06519 | 2012-07-27 |
| 1669736765 | Mayanka Tickoo | Internal Medicine | 300 Cedar St Fl 4, New Haven, CT 06519 | 2012-07-03 |
| 1730441627 | Judith A Ross | Physical Therapist | 18 Tower Lane, Tower One Tower East, New Haven, CT 06519 | 2012-06-15 |
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| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| 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 |
|---|---|---|---|---|
| 1679757629 | William Gee Chang | Internal Medicine | Bb114 330 Cedar St, Yale Nephrology, New Haven, CT 06520 | 2007-12-27 |
| 1558346056 | Daniel I Geisser | Internal Medicine | 55 Lock St, Yale Health, New Haven, CT 06511-3603 | 2005-12-07 |
| 1275518771 | Stephen J Huot | Internal Medicine | 789 Howard Avenue, Dana Building 3rd Floor, New Haven, CT 06510-8056 | 2005-12-07 |
| 1548640501 | Irene Chernova | Internal Medicine | 330 Cedar St # Bb114, New Haven, CT 06510-3218 | 2015-06-04 |
| 1366850711 | Faisal Radwi | Internal Medicine | 20 York St, New Haven, CT 06510-3220 | 2014-07-29 |
| 1346660552 | Sarthak Virmani | Internal Medicine | 800 Howard Ave, New Haven, CT 06519-1369 | 2014-04-27 |
| 1649527649 | Dennis Moledina | Internal Medicine | 330 Cedar St # Bb114, New Haven, CT 06510-3218 | 2012-08-08 |
| 1881915601 | Jeffrey Turner | Internal Medicine | 20 York St, New Haven, CT 06510-3220 | 2010-06-16 |
| 1477785285 | Robert Alpern | Internal Medicine | 333 Cedar St, C203 Shm, New Haven, CT 06510-3206 | 2009-08-12 |
| 1285877704 | Whitney Besse | Internal Medicine | 20 York St, Yale-new Haven Hospital, New Haven, CT 06510 | 2009-04-14 |
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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.