MASONICARE PRIMARY CARE PHYSICIANS (NPI# 1922084540) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922084540 |
| Entity Type | Organization |
| Organization Name | MASONICARE PRIMARY CARE PHYSICIANS |
| Practice Address |
67 Masonic Avenue 1st Floor Wallingford CT 06492 |
| Practice Telephone | 2032650355 |
| Practice Fax Number | 2032657413 |
| Mailing Telephone | 2032650355 |
| Mailing Fax Number | 2032657413 |
| Enumeration Date | 2005-12-15 |
| Last Update Date | 2008-01-02 |
| Authorized Official Name | ALLA BERNSHTEYN (PRESIDENT) |
| Authorized Official Telephone | 2032650355 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RG0300X |
Internal Medicine Specialization: Geriatric Medicine |
Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 004178605 | 05 |
| Street Address |
67 MASONIC AVENUE 1ST FLOOR |
| City | WALLINGFORD |
| State | CT |
| Zip Code | 06492 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891310215 | The Promptcare Companies, Inc. | Durable Medical Equipment & Medical Supplies | 101 Noth Plains Industrial Park, Suite B Building 2 Harvest Park, Wallingford, CT 06492 | 2020-06-11 |
| 1528692480 | Hilary Caitlin Sullivan | Nurse Practitioner | Park Avenue Medical, LLC, 85 Barnes Road, Suite 202, Wallingford, CT 06492 | 2020-02-28 |
| 1902370943 | Alicia Anne Eldridge | Student in an Organized Health Care Education/Training Program | 88 Cheshire Road, Wallingford, CT 06492 | 2019-01-13 |
| 1114409562 | Doreen Gail Barile | Pharmacist | 846 North Colony Road, Wallingford, CT 06492 | 2018-09-02 |
| 1942782354 | Brad Becker | Pharmacist | 846 North Colony Rd, Walingford, CT 06492 | 2018-08-31 |
| 1477041564 | Melissa A Fazzolari | Nurse Practitioner | 850 N Main Street Ext Ste B, Wallingford, CT 06492 | 2018-04-25 |
| 1992235857 | Karen Ann Meers | Behavioral Analyst | 29 North Plains Highway, Unit 15, Wallingford, CT 06492 | 2017-06-14 |
| 1992232698 | Chelsea Clements | Occupational Therapist | 87 Southwind Dr, Wallingford, CT 06492 | 2017-05-12 |
| 1659822369 | Sara Frawley | Naturopath | 850 N. Main Street Extention, Building 2 Suite 3c, Wallingford, CT 06492 | 2016-10-18 |
| 1083085518 | Energetic Spine Chiropractic | Chiropractor | 1271 South Broad St., Unit #11, Wallingford, CT 06492 | 2015-10-09 |
| Find all providers in zip 06492 | ||||
| Taxonomy Code | 207RG0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Geriatric Medicine |
| An internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. |
| 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 |
|---|---|---|---|---|
| 1427612100 | Holistic Healing Partners, LLC | Internal Medicine | 290 Baxter Ln, Milford, CT 06460-6813 | 2019-04-28 |
| 1003113762 | Jennifer Anne Freimund | Internal Medicine | 1450 Chapel St Ste 107, New Haven, CT 06511-4405 | 2011-02-16 |
| 1720211444 | Joseph Daniel Demayo | Internal Medicine | 66 Skyline Dr, Middlebury, CT 06762-1717 | 2009-08-27 |
| 1679701882 | Southern Connecticut Geriatric & Preventive Medicine LLC | Internal Medicine | 4 Sagamore Cove Rd, Branford, CT 06405-5020 | 2009-06-25 |
| 1184896151 | Geriatric Medicine Consultants Home Visit Practice, LLC | Internal Medicine | 33 Birch Rd, West Hartford, CT 06119-1009 | 2008-03-30 |
| 1083814339 | Lefkowitz & Scollan, M.d.'s,llc | Internal Medicine | 469 E Main St, Meriden, CT 06450-6027 | 2007-07-24 |
| 1326116948 | Barney Spivack | Internal Medicine | 101 Long Lots Rd, Westport, CT 06880-3919 | 2006-12-01 |
| 1447267026 | Casey Ott | Internal Medicine | 22 Old Waterbury Rd # 103, Southbury, CT 06488-3848 | 2006-08-03 |
| 1447264155 | Audrey Lefkowitz | Internal Medicine | 469 E Main Street, Meriden, CT 06450 | 2006-07-28 |
| 1477583540 | Geraldine M Fabregas | Internal Medicine | 280 Alden Ave, New Haven, CT 06515-2114 | 2006-07-04 |
| Find all providers with the same taxonomy | ||||
| City | WALLINGFORD |
| Zip Code | 06492 |
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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.