BACK TO HEALTH OF BRANFORD, LLC (NPI# 1215958772) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215958772 |
| Entity Type | Organization |
| Organization Name | BACK TO HEALTH OF BRANFORD, LLC |
| Practice Address |
400 West Main Street Branford CT 06405 |
| Mailing Address |
400 W Main St Branford CT 06405-3416 |
| Practice Telephone | 2034837778 |
| Practice Fax Number | 2034810234 |
| Mailing Telephone | 2034837778 |
| Mailing Fax Number | 2034810234 |
| Enumeration Date | 2006-07-21 |
| Last Update Date | 2014-12-22 |
| Authorized Official Name | SHARON L BAILEY (OFFICE ADMINISTRATOR) |
| Authorized Official Telephone | 2034837778 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111NI0900X |
Chiropractor Specialization: Internist |
000561 | CT | Chiropractic Providers |
| N | 111N00000X | Chiropractor | 148 | CT | Chiropractic Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
002765 | CT | Physician Assistants & Advanced Practice Nursing Providers |
| N | 111N00000X | Chiropractor | 001614 | CT | Chiropractic Providers |
| Y | 207R00000X | Internal Medicine | 037255 | CT | Allopathic & Osteopathic Physicians |
| N | 335E00000X | Prosthetic/Orthotic Supplier | 037255 | CT | Suppliers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | 037255 | CT | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 008038901 | 05 | |
| GROUP | C02868 | 01 | |
| CT | 008038939 | 05 | |
| CT | CLIA WAIVER | 07D1072612 | 01 |
| Street Address |
400 WEST MAIN STREET |
| City | BRANFORD |
| State | CT |
| Zip Code | 06405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174767768 | Andrea Benko | Chiropractor | 400 West Main Street, Branford, CT 06405 | 2009-04-27 |
| 1891857231 | Richard Samoska | Chiropractor | 400 West Main Street, Branford, CT 06485 | 2006-12-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770119596 | Katarzyna Pavelko | Physical Therapist | Branford Hills, 189 Alps Rd, Branford, CT 06405 | 2020-03-13 |
| 1174027213 | C & M Health Services Branford LLC | Home Health | 625 East Main Street, Branford, CT 06405 | 2018-03-22 |
| 1689181554 | Erin H Mccarthy | Social Worker | 513 Leetes Island Rd, Branford, CT 06405 | 2018-01-02 |
| 1255860516 | Sylcom Angelscare LLC | In Home Supportive Care | 1204 Main Street #241, Branford, CT 06405 | 2017-06-08 |
| 1093266439 | Emmanuel Chery | Physical Therapy Assistant | 153 Austin Ryer Lane, Branford, CT 06405 | 2016-10-20 |
| 1114389681 | Suraj Patel | Pharmacist | 2-6 Short Beach Rd, Branford, CT 06405 | 2016-03-24 |
| 1558753897 | Donald Ray Sirry | Social Worker | 9 Business Park Drive, Unit 1, Branford, CT 06405 | 2015-02-24 |
| 1952679110 | Maria Rivera Heath Lmft, LLC | Marriage & Family Therapist | 388 East Main Street, Suite 19, Branford, CT 06405 | 2011-12-02 |
| 1942587035 | Kathryn Lyn Delia | Pharmacist | 329 East Main St, Branford, CT 06405 | 2011-11-03 |
| 1447554068 | Elizabeth's Home Health Care Agency L.L.C. | Home Health | 127 Cedar Street, Bronford, CT 06405 | 2010-12-23 |
| Find all providers in zip 06405 | ||||
| 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 |
|---|---|---|---|---|
| 1912147307 | Joseph Charles Esposito | Internal Medicine | 136 Alps Rd, Branford, CT 06405 | 2009-02-25 |
| 1992961775 | Sergey Zasypayko | Internal Medicine | 14 Business Park Drive, Branford, CT 06405 | 2008-07-31 |
| 1447443676 | Antonio Daria Jr. | Internal Medicine | 4 Brushy Plain Rd, Suite 519, Branford, CT 06405-6000 | 2007-08-21 |
| 1689770372 | Wesley Maunder Vietzke | Internal Medicine | 15 W Haycock Point Rd, Branford, CT 06405-5307 | 2006-09-16 |
| 1205843554 | Jon Michael Fessel | Internal Medicine | 420 E Main Street, Building 2 Suite 3, Branford, CT 06405 | 2006-08-01 |
| 1477574929 | Si-hoi Lam | Internal Medicine | 173 Montowese St, Branford, CT 06405-3824 | 2006-07-21 |
| 1134154917 | Belinda Juliet Chan | Internal Medicine | 420 E Main St Ste 3, Branford, CT 06405-2941 | 2006-07-11 |
| 1699723049 | Mark Anthony Perrotti | Internal Medicine | 251 W Main St, Branford, CT 06405-4047 | 2006-05-05 |
| 1437141363 | James J. Zumpano | Internal Medicine | 144 N Main St, Branford, CT 06405-3044 | 2005-08-17 |
| 1386643807 | Monica M Munteanu | Internal Medicine | 420 E Main St, Suite#3, Branford, CT 06405-2940 | 2005-07-18 |
| Find all providers in BRANFORD | ||||
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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.