PHYSICIAN SERVICES OF NORTHEAST (NPI# 1275801771) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275801771 |
| Entity Type | Organization |
| Organization Name | PHYSICIAN SERVICES OF NORTHEAST |
| Other Organization Name | PHYSICIAN SERVICES OF NORTHEAST CT, LLC |
| Practice Address |
320 Pomfret St Suite Csb2 Putnam CT 06260-1836 |
| Mailing Address |
320 Pomfret St Putnam CT 06260-1836 |
| Practice Telephone | 8609286541 |
| Practice Fax Number | 8609636450 |
| Mailing Telephone | 8609286541 |
| Mailing Fax Number | 8609636450 |
| Enumeration Date | 2011-12-12 |
| Last Update Date | 2011-12-30 |
| Authorized Official Name | JULIE DROUIN (CFO) |
| Authorized Official Telephone | 8609286541 |
| Is Organization Subpart | Y |
| Parent Organization Name | DAY KIMBALL HOSPITAL OF WINDHAM COUNTY |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207VM0101X |
Obstetrics & Gynecology Specialization: Maternal & Fetal Medicine |
Allopathic & Osteopathic Physicians | ||
| Y | 207V00000X | Obstetrics & Gynecology | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| PHYSICIAN SERVICES OF NORTHEAST CT, LLC | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174809966 | Physician Services of Northeast | Midwife | 320 Pomfret St, Putnam, CT 06260-1836 | 2011-10-25 |
| 1669603767 | Physician Services of Northeast | Nurse Practitioner | 320 Pomfret St, Suite, Csb2, Putnam, CT 06260-1836 | 2009-08-06 |
| 1891962221 | Physician Services of Northeast | Surgery | 320 Pomfret St, Suite Csb2, Putnam, CT 06260-1836 | 2008-05-14 |
| Street Address |
320 POMFRET ST SUITE CSB2 |
| City | PUTNAM |
| State | CT |
| Zip Code | 06260-1836 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417940271 | Marc B Cerrone | Pediatrics | 320 Pomfret St, Dkh Pediatric Center, Putnam, CT 06260-1836 | 2005-08-26 |
| 1265065551 | Vanmaly P. Sangasy | Nurse Practitioner | 320 Pomfret St, Putnam, CT 06260-1836 | 2020-02-15 |
| 1952942310 | Jeremy Tyler Rockwell | Registered Nurse | 320 Pomfret St, Putnam, CT 06260-1836 | 2019-10-07 |
| 1215588355 | Caitlyn Allyssa Sward | Dietitian, Registered | 320 Pomfret St, Putnam, CT 06260-1836 | 2019-09-20 |
| 1164082301 | Julie Van Saun | Physician Assistant | 320 Pomfret St, Putnam, CT 06260-1836 | 2019-06-19 |
| 1487127171 | Hartford Orthopedic Surgeons,pc | Durable Medical Equipment & Medical Supplies | 320 Pomfret St, Putnam, CT 06260-1836 | 2019-01-07 |
| 1518434422 | Betsy Alvarado | Physician Assistant | 320 Pomfret St, Putnam, CT 06260-1836 | 2018-10-29 |
| 1831601848 | Robyn A Martin | Obstetrics & Gynecology | 320 Pomfret St, Putnam, CT 06260-1836 | 2017-10-31 |
| 1922529098 | Raphaella Daggett | Nurse Practitioner | 320 Pomfret St, Putnam, CT 06260-1836 | 2017-06-29 |
| 1770010399 | Gurkirat Singh Sandhu | Internal Medicine | 320 Pomfret St, Putnam, CT 06260-1836 | 2017-05-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043838139 | Shayna Marie Robinson | Behavior Technician | 62 Providence Pike Suite E, Putnam, CT 06260 | 2020-07-06 |
| 1649896390 | Bethany Barrette | Behavior Technician | 682 Providence Pike Suite E, Putnam, CT 06260 | 2020-06-18 |
| 1902450448 | Jillian Bellman | Registered Nurse | 391 Pomfret Street, Putnam, CT 06260 | 2019-08-01 |
| 1285297390 | Jourhana Colon | Behavior Technician | 62 Providence Pike Ste E, Putnam, CT 06260 | 2019-04-16 |
| 1457839417 | Amplisound, Inc. | Hearing Instrument Specialist | 19 Quinebaug Avenue, Putnam, CT 06260 | 2018-08-01 |
| 1184095960 | Lori Bergeron | Counselor | 391 Pomret Street, Putnam, CT 06260 | 2015-10-19 |
| 1558619957 | Merinessa Macayaon Quintilla | Physical Therapist | 10 Thurber Road, Genesis - Matulaitis Nursing Home, Putnam, CT 06260 | 2012-08-16 |
| 1235496936 | Mohsin Haseeb | Internal Medicine | Day Kimball Hospital, 320 Pomfret Street, Putnam, CT 06260 | 2012-04-18 |
| 1588932529 | Lifehouse Community Care, LLC | Home Health | 554 Liberty Highway Unit 2, Putnam, CT 06260 | 2011-12-05 |
| 1942433032 | Connecticut Cvs Pharmacy, LLC | Durable Medical Equipment & Medical Supplies | 57 Providence Pike, Putnam, CT 06260 | 2009-08-24 |
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| Taxonomy Code | 207V00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306848155 | Steven Theodore Raheb | Obstetrics & Gynecology | 340 Pomfret St, Putnam, CT 06260-1834 | 2005-08-11 |
| 1831601848 | Robyn A Martin | Obstetrics & Gynecology | 320 Pomfret St, Putnam, CT 06260-1836 | 2017-10-31 |
| 1932596244 | Amna Aziz | Obstetrics & Gynecology | 320 Pomfret St, Putnam, CT 06260 | 2015-04-24 |
| 1750797379 | Devon Jacobson | Obstetrics & Gynecology | 320 Pomfret St, Putnam, CT 06260-1836 | 2014-07-02 |
| 1265842959 | Regan Murchison | Obstetrics & Gynecology | 320 Pomfret St, Putnam, CT 06260-1836 | 2014-05-02 |
| 1366638009 | The Womens Health Center of Putnam,ct, PC | Obstetrics & Gynecology | 340 Pomfret St, Putnam, CT 06260-1834 | 2007-09-17 |
| 1053375915 | Andrew Paul Mackenzie | Obstetrics & Gynecology | 346 Pomfret St, Putnam, CT 06260-1871 | 2006-04-17 |
| 1740255959 | Erica Kesselman | Obstetrics & Gynecology | 320 Pomfret St, Putnam, CT 06260-1836 | 2006-02-21 |
| 1386617983 | David Lee Yeager | Obstetrics & Gynecology | 346 Pomfret St, Putnam, CT 06260-1871 | 2006-02-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336658186 | Amy Frassetto | Obstetrics & Gynecology | 40 Robinwood Rd, Trumbull, CT 06611-4924 | 2017-09-25 |
| 1447770417 | Barbara Lynn Tendler | Obstetrics & Gynecology | 25 River Rd Apt 5101, Wilton, CT 06897-4085 | 2017-06-21 |
| 1528506516 | William P Guinan, Md and Associates LLC | Obstetrics & Gynecology | 25 Oakland Road, South Windsor, CT 06074 | 2017-02-09 |
| 1669822607 | Tania Plaisimond | Obstetrics & Gynecology | 761 Main Ave Ste 100, Norwalk, CT 06851-1080 | 2016-06-21 |
| 1720435092 | Eric Han | Obstetrics & Gynecology | 100 West Campus Drive, Orange, CT 06477 | 2016-05-17 |
| 1093179624 | Jessica Lovesky | Obstetrics & Gynecology | 85 Seymour St Ste 1019, Hartford, CT 06106-5530 | 2016-04-10 |
| 1164895314 | Naugatuck Valley Womens Health Specialists PC | Obstetrics & Gynecology | 686 Straits Turnpike, 2a, Middlebury, CT 06762 | 2015-11-10 |
| 1205218682 | Rui Wang | Obstetrics & Gynecology | 85 Seymour St Ste 525, Hartford, CT 06106-5525 | 2015-06-23 |
| 1164803003 | Ashley Rachelle Christensen | Obstetrics & Gynecology | 5520 Park Ave Ste 302, Trumbull, CT 06611-3466 | 2015-06-16 |
| 1578959086 | Tanya Glenn | Obstetrics & Gynecology | 333 Cedar St Ste 302, New Haven, CT 06510-3206 | 2015-04-10 |
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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.