COASTAL DIGESTIVE DISEASES PC (NPI# 1053441147) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053441147 |
| Entity Type | Organization |
| Organization Name | COASTAL DIGESTIVE DISEASES PC |
| Practice Address |
234 Bank St 4th Floor New London CT 06320-6070 |
| Mailing Address |
234a Bank St 4th Floor New London CT 06320-6054 |
| Practice Telephone | 8604420290 |
| Practice Fax Number | 8604422136 |
| Mailing Telephone | 8604420290 |
| Mailing Fax Number | 8604422136 |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2011-12-07 |
| Authorized Official Name | DR. GEORGE S OUELLETTE (PRESIDENT) |
| Authorized Official Telephone | 8604420290 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207RG0100X |
Internal Medicine Specialization: Gastroenterology |
3032224000 | CT | Allopathic & Osteopathic Physicians |
| Y | 207QA0505X |
Family Medicine Specialization: Adult Medicine |
3032224000 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
234 BANK ST 4TH FLOOR |
| City | NEW LONDON |
| State | CT |
| Zip Code | 06320-6070 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942824891 | Shilpi Jain | Physical Therapist | 31 Vauxhall Street, Beechwood Post Accute, Transitional, New London, CT 06320 | 2020-06-05 |
| 1174009641 | Catherine Hinojosa | Nurse Practitioner | 1 Shaws Cove, New London, CT 06320 | 2018-07-17 |
| 1043668320 | Cultivate & Grow Inc. | Counselor | 302 State St Suite 307, New London, CT 06320 | 2016-05-27 |
| 1295137263 | Jacqueline Durnell | Registered Nurse | 15 Mohegan Drive, Us Coast Guard Academy Regional Clinic, New London, CT 06320 | 2014-09-22 |
| 1922427541 | Corina Vendetto | Registered Nurse | 245 Shaw St., New London, CT 06320 | 2014-04-10 |
| 1912329962 | Janelle Posey-green | Social Worker | 302 State St., Suite 201, New London, CT 06320 | 2014-01-10 |
| 1750622692 | Cynthia Mitchell | Social Worker | 65b Michael Rd, New London, CT 06320 | 2013-03-01 |
| 1518254507 | Simon J Shapiro | Physical Medicine & Rehabilitation | 190 Howard Avenue, New London, CT 06320 | 2011-06-29 |
| 1184876708 | Jane P Genido-trujillo | Nurse Practitioner | 270 Mohegan Ave., Student Health Services, New London, CT 06320 | 2008-10-14 |
| 1932356284 | Gerard Joseph Ventura | Dentist | 21 Montauk Ave., Suite 102, New London, CT 06320 | 2008-08-19 |
| Find all providers in zip 06320 | ||||
| Taxonomy Code | 207QA0505X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Adult Medicine |
| Definition to come. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871067447 | Christina Marie Bolduc Falzone | Family Medicine | 35 Talcottville Rd Ste 1, Vernon, CT 06066-5261 | 2019-01-17 |
| 1760724165 | John Ordway Alden | Family Medicine | 20 Loeffler Rd, T521c, Bloomfield, CT 06002-2276 | 2013-03-23 |
| 1598098881 | Anita Boyd Bennett | Family Medicine | 1249 Boulevard, West Hartford, CT 06119-1603 | 2009-09-17 |
| 1740329168 | Seymour Isaac Kummer | Family Medicine | 67 N Park St, Ellington, CT 06029-4135 | 2007-02-05 |
| 1225101991 | Syed Hyder Reza | Family Medicine | 345 Main Ave, Pmcc, Norwalk, CT 06851-1547 | 2006-11-17 |
| 1356433486 | Windsor Locks Medical Center, LLP | Family Medicine | 73 Old County Road, Windsor Locks, CT 06096 | 2006-09-28 |
| 1609982834 | Angelika Jovin | Family Medicine | 27 Commerce St, Clinton, CT 06413-2054 | 2006-08-21 |
| 1720014798 | James M. Perlotto | Family Medicine | 55 Lock St., New Haven, CT 06520-8237 | 2006-06-23 |
| 1184666430 | Alicja Jadwiga Harbut IIi | Family Medicine | 25 Clinton St, New Britain, CT 06053-3509 | 2006-06-12 |
| 1740265925 | Yogesh Kumar Katechia | Family Medicine | 2 Lathrop Ave, Norwich, CT 06360-2309 | 2005-12-11 |
| Find all providers with the same taxonomy | ||||
| City | NEW LONDON |
| Zip Code | 06320 |
Please comment or provide details below to improve the information on COASTAL DIGESTIVE DISEASES PC.
| 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.