MEDICAL SPECIALISTS OF FAIRFIELD, LLC (NPI# 1144303892) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144303892 |
| Entity Type | Organization |
| Organization Name | MEDICAL SPECIALISTS OF FAIRFIELD, LLC |
| Practice Address |
4699 Main Street Fairfield CT 06824 |
| Practice Telephone | 2032554545 |
| Mailing Telephone | 2032554545 |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | GLENN REZNIKOFF (AUTHORIZED OFFICIAL) |
| Authorized Official Telephone | 2032554545 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RH0003X |
Internal Medicine Specialization: Hematology & Oncology |
Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760563746 | Medical Specialists of Fairfield, LLC | Durable Medical Equipment & Medical Supplies | 425 Post Rd, South Lobby, Fairfield, CT 06824-6232 | 2006-10-18 |
| 1700864097 | Medical Specialists of Fairfield, LLC | Durable Medical Equipment & Medical Supplies | 2800 Main St, 3rd Flr, Bridgeport, CT 06606-4201 | 2006-01-06 |
| Street Address |
4699 MAIN STREET |
| City | FAIRFIELD |
| State | CT |
| Zip Code | 06824 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942819826 | Lauren J Cotton | Student in an Organized Health Care Education/Training Program | 1073 North Benson Road, Fairfield, CT 06824 | 2020-07-28 |
| 1831652064 | Seagull Counseling & Therapy LLC | Social Worker | 35 Nutmeg Lane, Fairfield, CT 06824 | 2019-04-14 |
| 1871018390 | Richard Matthew Carraway | Nurse Practitioner | 117 Carlynn Drive, Fairfield, CT 06824 | 2017-08-05 |
| 1811426695 | Fairfield County Health & Wellness Services II LLC | Psychiatry & Neurology | 325 Reef Road/suite 109, Fairfield, CT 06824 | 2017-06-06 |
| 1487198214 | Evamarie Koehler Elinskas | Speech-Language Pathologist | 50 Potters Lane, Fairfield, CT 06824 | 2016-12-13 |
| 1447794441 | Nicholas C Kopazna | Counselor | 433 Meadow St, Fairfield, CT 06824 | 2016-12-09 |
| 1245686997 | Tyler Wayne Vitzthum | Chiropractor | 1995 Post Rd., Fairfield, CT 06824 | 2016-05-12 |
| 1184087660 | Beth Segaloff | Social Worker | 191 Catherine Terrace, Fairfield, CT 06824 | 2016-04-01 |
| 1518342781 | April Vanbergen | Counselor | 1275 Post Rd., Suite A5, Fairfield, CT 06824 | 2015-07-29 |
| 1982089181 | Mary Cilio | Social Worker | 173 Samp Mortar Drive, Fairfield, CT 06824 | 2015-07-29 |
| Find all providers in zip 06824 | ||||
| Taxonomy Code | 207RH0003X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Hematology & Oncology |
| An internist doctor of osteopathy that specializes in the treatment of the combination of hematology and oncology disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine WAS able to obtain a Certificate of Special Qualifications in the field of Hematology and Oncology. The Certificate is NO longer offered. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: definiton added, source added; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972529873 | Piyush Vinaykumar Patel | Internal Medicine | 3050 Mack Rd Ste 300, Fairfield, OH 45014-5376 | 2006-07-14 |
| 1780688275 | Oncology/ Hematology Care, Inc. | Internal Medicine | 3050 Mack Rd, Suite 300, Fairfield, OH 45014-5379 | 2005-06-13 |
| 1972507564 | Oncology/ Hematology Care, Inc. | Internal Medicine | 2960 Mack Rd, Ste 105, Fairfield, OH 45014-5374 | 2005-06-10 |
| 1124388384 | Christin B Destefano | Internal Medicine | 101 Bodin Cir, Fairfield, CA 94535-1809 | 2012-05-22 |
| 1609163260 | Nicholas Brand Pleat | Internal Medicine | 3050 Mack Rd, Fairfield, OH 45014-5379 | 2011-07-05 |
| 1649492166 | Kanwaldeep Kaur Rasila | Internal Medicine | 2720 Low Court, Fairfield, CA 94534-9771 | 2007-05-03 |
| 1497877500 | Yelena Krijanovski | Internal Medicine | 2702 Low Ct, Fairfield, CA 94534-9771 | 2007-04-06 |
| 1013094382 | Prasad R Kudalkar | Internal Medicine | 3050 Mack Rd Ste 300, Fairfield, OH 45014-5376 | 2006-11-01 |
| 1194821868 | James Long | Internal Medicine | 1860 Pennsylvania Ave, Suite 230, Fairfield, CA 94533-3590 | 2006-09-16 |
| 1558301267 | Edward J Crane | Internal Medicine | 3050 Mack Rd, Ste 300, Fairfield, OH 45014-5379 | 2006-06-08 |
| Find all providers in FAIRFIELD | ||||
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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.