DR. EVAN R HACK (NPI# 1184621435) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1184621435 |
| Entity Type | Individual |
| Full Name | DR. EVAN R HACK |
| Credential | MEDICAL DOCTOR |
| Practice Address |
120 Park Ln Suite A-101 New Milford CT 06776-2428 |
| Mailing Address |
47 Putnam Rd New Milford CT 06776-5332 |
| Practice Telephone | 8603558190 |
| Practice Fax Number | 8603553856 |
| Mailing Telephone | 8603553790 |
| Mailing Fax Number | 8603553856 |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2017-01-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 029133 | CT | Allopathic & Osteopathic Physicians |
| Street Address |
120 PARK LN SUITE A-101 |
| City | NEW MILFORD |
| State | CT |
| Zip Code | 06776-2428 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366449324 | Frank Fanella Jr. | Pediatrics | 120 Park Ln, Suite A-101, New Milford, CT 06776-2428 | 2005-07-06 |
| 1538166806 | Matthew Glen Abel | Pediatrics | 120 Park Ln, Suite A 101, New Milford, CT 06776-2428 | 2005-07-01 |
| 1982601266 | Wendy H Drost | Pediatrics | 120 Park Ln, Suite A-101, New Milford, CT 06776-2428 | 2005-07-01 |
| 1568469831 | Kristi F Beck | Pediatrics | 120 Park Ln, Suite A-101, New Milford, CT 06776-2428 | 2005-07-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639680879 | Foot & Ankle Specialists of Ct PC | Podiatrist | 7 Pickett District Road, New Milford, CT 06776 | 2017-10-16 |
| 1477715035 | Abra Grize Mabasa | Family Medicine | 169 Danberry Rd., New Milford, CT 06776 | 2008-06-25 |
| 1134393259 | Brian A Fusillo | Dentist | One Aspetuck Ave, New Milford, CT 06776 | 2008-04-18 |
| 1972791499 | New Milford Chiropractic | Chiropractor | 5 Old Town Park Road, South End Plaza Unit 70, New Milford, CT 06776 | 2007-10-10 |
| 1366637084 | Mary Mackessy | Emergency Medicine | 21 Elm Street, New Milford, CT 06776 | 2007-09-06 |
| 1659407021 | Margaret Martha Babington | Specialist/Technologist | 101 Aspetuck Ave, Canterbury School, New Milford, CT 06776 | 2007-02-27 |
| 1053448456 | Lisa Gay Witham | Specialist/Technologist | 101 Aspetuck Ave., Canterbury School, New Milford, NH 06776 | 2007-02-27 |
| 1710049754 | Linda Gail Smith | Social Worker | New Milford Hospital Behavioral Health Services, 18 Elm St, New Milford, CT 06776 | 2006-12-15 |
| 1881777597 | Candlewood New Milford LLC | Skilled Nursing Facility | 30 Park Lane East, New Milford, CT 06776 | 2006-10-24 |
| 1417030651 | Interface Center Inc | Counselor | 46 Danbury Rd, Suite 6, New Milford, CT 06776 | 2006-10-23 |
| Find all providers in zip 06776 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811021066 | Candlewood Valley Pediatrics, P.C. | Pediatrics | 120 Park Lane Rd Ste A101, New Milford, CT 06776-2444 | 2007-03-16 |
| 1396766101 | Emelina J Goyco | Pediatrics | 140 Henley Avenue, New Milford, NJ 07646 | 2006-07-21 |
| 1700887395 | Josef J Burton | Pediatrics | 41 S Main St, New Milford, CT 06776-3507 | 2005-08-03 |
| 1710434840 | Diane D'isidori | Pediatrics | 120 Park Lane Rd, Suite A101, New Milford, CT 06776-2444 | 2016-09-07 |
| 1255761904 | Emelina Goyco, Md PC | Pediatrics | 140 Henley Ave, New Milford, NJ 07646-2947 | 2013-11-16 |
| 1235479742 | Roman Alder Md LLC | Pediatrics | 4 Main St, New Milford, CT 06776-2802 | 2013-02-20 |
| 1891920625 | Stephanie Teresa Tiso | Pediatrics | 120 Park Lane Rd, Suite A-101, New Milford, CT 06776-2444 | 2009-05-22 |
| 1255355764 | Roman Alder | Pediatrics | 41 S Main St, New Milford, CT 06776-3507 | 2006-07-27 |
| 1982666277 | Pediatrics P.c> | Pediatrics | 41 S Main St, New Milford, CT 06776-3507 | 2006-04-04 |
| 1366449324 | Frank Fanella Jr. | Pediatrics | 120 Park Ln, Suite A-101, New Milford, CT 06776-2428 | 2005-07-06 |
| Find all providers in NEW MILFORD | ||||
| City | NEW MILFORD |
| Zip Code | 06776 |
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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.