GREATER WATERBURY PRIMARY CARE ASSOC (NPI# 1033167804) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033167804 |
| Entity Type | Organization |
| Organization Name | GREATER WATERBURY PRIMARY CARE ASSOC |
| Practice Address |
166 Waterbury Road Ste 300 Prospect CT 06712 |
| Practice Telephone | 2037580878 |
| Practice Fax Number | 2037580877 |
| Mailing Telephone | 2037580878 |
| Mailing Fax Number | 2037580877 |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DENNIS C KING (SECRETARY) |
| Authorized Official Telephone | 2037580878 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207R00000X | Internal Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
166 WATERBURY ROAD STE 300 |
| City | PROSPECT |
| State | CT |
| Zip Code | 06712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154343739 | Prospect Diagnostic Imaging | Clinic/Center | 166 Waterbury Road, Rte 69, Prospect, CT 06712 | 2006-07-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679746440 | Debra Anne Hudobenko | Social Worker | 40 Union City Rd Ste 2b, Prospect, CT 06712 | 2008-04-11 |
| 1831230739 | Jeffrey Paul Dalessandro | Pharmacist | Ezpharm Pharmacy, 166 Waterbury Rd, Prospect, CT 06712 | 2007-02-12 |
| 1497817464 | Kenneth Robert Capozzi | Dentist | 2 Summit Rd, Prospect, CT 06712 | 2006-12-15 |
| 1821160961 | Jeremy August | Psychiatry & Neurology | 39a Waterbury Road, Prospect, CT 06712 | 2006-11-14 |
| 1831260850 | Thomas J Deluca | Optometrist | 67 Waterbury Rd, Prospect, CT 06712 | 2006-11-13 |
| 1578648606 | Renika N Mcleod-labissiere | Family Medicine | 115 Waterbury Road, Prospect, CT 06712 | 2006-10-26 |
| 1750461836 | Eye Care Associates | Optometrist | 67 Waterbury Road, Prospect, CT 06712 | 2006-10-16 |
| 1124123948 | Carmelita Viega Rifkin | Physical Therapist | 93 Waterbury Rd, Prospect, CT 06712 | 2006-09-14 |
| 1730141730 | Amy Y Tso | Ophthalmology | 166 Waterbury Rd., Suite 201, Prospect, CT 06712 | 2006-04-05 |
| 1124680269 | Nabeel Qureshi | Internal Medicine | 73 Waterbury Road, Suite 1, Prospect, CT 06712 | 2019-06-28 |
| Find all providers in zip 06712 | ||||
| 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 |
|---|---|---|---|---|
| 1821330861 | James L. Bersot Jr. | Internal Medicine | 2406 Belknap Beach Rd, Prospect, KY 40059-9050 | 2013-03-16 |
| 1790077287 | Aditi Mukherji | Internal Medicine | 166 Waterbury Rd Ste 300, Prospect, CT 06712-1246 | 2011-05-03 |
| 1467782466 | Advanced Medical Services | Internal Medicine | 13003 Tattersall Ln, Prospect, KY 40059-9718 | 2010-01-13 |
| 1811124472 | Daniel Bernheim Penner | Internal Medicine | 7211 Leafland Pl, Prospect, KY 40059-9687 | 2009-06-22 |
| 1295758514 | Tina T Yuan | Internal Medicine | 9537 Us Highway 42, Prospect, KY 40059-9301 | 2006-07-26 |
| 1710924055 | Nasir Gardezi | Internal Medicine | 9500 Hayden Creek Court, Prospect, KY 40059 | 2006-06-02 |
| 1932164134 | Elizabeth V. Bates | Internal Medicine | 9409 Norton Commons Blvd Ste 101, Prospect, KY 40059-7525 | 2006-04-19 |
| 1689638470 | Lynn O. Egan | Internal Medicine | 12945 W Highway 42, Prospect, KY 40059-9107 | 2006-04-17 |
| 1861492373 | Beyla Zuberi | Internal Medicine | 10727 Worthington Ln, Prospect, KY 40059-9586 | 2005-07-26 |
| 1215933080 | Reem Hamad | Internal Medicine | 6041 Timber Ridge Dr, Prospect, KY 40059-8134 | 2005-06-24 |
| Find all providers in PROSPECT | ||||
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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.