AYAZ T MADRASWALLA (NPI# 1902899859) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902899859 |
| Entity Type | Individual |
| Full Name | AYAZ T MADRASWALLA |
| Credential | MD |
| Practice Address |
391 Pomfret St Putnam CT 06260-1852 |
| Mailing Address |
2 Waterside Xing Ste 401 Windsor CT 06095-1588 |
| Practice Telephone | 8607315522 |
| Mailing Telephone | 8607315522 |
| Mailing Fax Number | 8607315522 |
| Enumeration Date | 2005-08-25 |
| Last Update Date | 2020-01-22 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | 34327 | CT | Allopathic & Osteopathic Physicians |
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
034327 | CT | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 34 Professional Park Rd., Storrs, CT 06268 | 8604870002 | 8604291663 |
| Street Address |
391 POMFRET ST |
| City | PUTNAM |
| State | CT |
| Zip Code | 06260-1852 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962017913 | Allyson A Vandi | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2020-09-15 |
| 1881207645 | Joseph Coulanges | Licensed Practical Nurse | 391 Pomfret St, Putnam, CT 06260-1852 | 2020-08-31 |
| 1134737125 | George Mcdonald | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2020-07-16 |
| 1699396994 | Ashley Carpenter | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2020-04-28 |
| 1114566981 | Randy N Munasami | Licensed Practical Nurse | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-12-27 |
| 1023669637 | Jordan Jones | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-09-25 |
| 1801445291 | Chelsea Scanlon | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-09-09 |
| 1528615119 | Kerri A Mccaughey | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-08-20 |
| 1831744168 | Eddy Pimental | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-08-05 |
| 1104487586 | Victoria Burbank | Counselor | 391 Pomfret St, Putnam, CT 06260-1852 | 2019-06-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043838139 | Shayna Marie Robinson | Behavior Technician | 62 Providence Pike Suite E, Putnam, CT 06260 | 2020-07-06 |
| 1649896390 | Bethany Barrette | Behavior Technician | 682 Providence Pike Suite E, Putnam, CT 06260 | 2020-06-18 |
| 1902450448 | Jillian Bellman | Registered Nurse | 391 Pomfret Street, Putnam, CT 06260 | 2019-08-01 |
| 1285297390 | Jourhana Colon | Behavior Technician | 62 Providence Pike Ste E, Putnam, CT 06260 | 2019-04-16 |
| 1457839417 | Amplisound, Inc. | Hearing Instrument Specialist | 19 Quinebaug Avenue, Putnam, CT 06260 | 2018-08-01 |
| 1184095960 | Lori Bergeron | Counselor | 391 Pomret Street, Putnam, CT 06260 | 2015-10-19 |
| 1558619957 | Merinessa Macayaon Quintilla | Physical Therapist | 10 Thurber Road, Genesis - Matulaitis Nursing Home, Putnam, CT 06260 | 2012-08-16 |
| 1235496936 | Mohsin Haseeb | Internal Medicine | Day Kimball Hospital, 320 Pomfret Street, Putnam, CT 06260 | 2012-04-18 |
| 1588932529 | Lifehouse Community Care, LLC | Home Health | 554 Liberty Highway Unit 2, Putnam, CT 06260 | 2011-12-05 |
| 1942433032 | Connecticut Cvs Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 57 Providence Pike, Putnam, CT 06260 | 2009-08-24 |
| Find all providers in zip 06260 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215993993 | Richard D Smith | Family Medicine | 320 Pomfret St, Putnam, CT 06260-1836 | 2006-04-22 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972127678 | Sound Recovery, Inc | Family Medicine | 110 Pellegrino Rd, Stonington, CT 06378-2129 | 2020-05-29 |
| 1043427115 | Lakshmi Basu | Family Medicine | 931 Bank St., New London, CT 06320-2702 | 2007-05-17 |
| 1083022230 | Staywell Health Care Inc | Family Medicine | 402 E Main St, Waterbury, CT 06702-1701 | 2014-07-31 |
| 1710312368 | Connecticut Addiction Medicine, LLC | Family Medicine | 546 Cromwell Ave, Suite 101, Rocky Hill, CT 06067-1800 | 2013-09-13 |
| 1275608879 | Christina Kolade | Family Medicine | 3851 Main St, Bridgeport, CT 06606-2864 | 2006-11-21 |
| 1972686707 | Virgil T Rona | Family Medicine | 500 Vine Street, Blue Hills Hosptial, Hartford, CT 06112 | 2006-10-23 |
| 1043239783 | Thomas R Defanti | Family Medicine | 75 Swantown Hl, North Stonington, CT 06359-1022 | 2006-07-19 |
| 1720017056 | Jay B Benson | Family Medicine | 546 Cromwell Ave, Suite 101, Rocky Hill, CT 06067-1800 | 2006-06-30 |
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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.