BEAVER POND BROOK EMERGENCY PHYSICIANS LLC (NPI# 1386173201) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1386173201 |
| Entity Type | Organization |
| Organization Name | BEAVER POND BROOK EMERGENCY PHYSICIANS LLC |
| Practice Address |
3081 E Main St Waterbury CT 06705-3424 |
| Mailing Address |
13737 Noel Rd Ste 1600 Dallas TX 75240-1374 |
| Practice Telephone | 4694012386 |
| Mailing Telephone | 4694012386 |
| Enumeration Date | 2017-06-05 |
| Last Update Date | 2017-06-05 |
| Authorized Official Name | RUSSELL HARRIS (OFFICER) |
| Authorized Official Telephone | 4694012386 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | Allopathic & Osteopathic Physicians |
| Street Address |
3081 E MAIN ST |
| City | WATERBURY |
| State | CT |
| Zip Code | 06705-3424 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598245037 | Karanbeer Singh Aulakh | Dentist | Smile & Shine Dental, 158 Manor Avenue, Waterbury, CT 06705 | 2018-08-15 |
| 1912495797 | Jennie Webb | Physician Assistant | 2247 E Main St Ste 103, Waterbury, CT 06705 | 2018-04-26 |
| 1558886671 | Macaela Cirish | Nurse Practitioner | 3801 East Main Street, Second Floor, Waterbury, CT 06705 | 2017-08-09 |
| 1033648464 | Mahwish Makhdoom | Pharmacist | 464 Reidville Drive, Waterbury, CT 06705 | 2017-06-08 |
| 1417407248 | Jaswinder Gulati | Dentist | 939 Wolcott Street Unit 5b, Waterbury, CT 06705 | 2016-10-05 |
| 1407272107 | Cori Capuano | Counselor | 230 Frost Rd Unit B, Waterbury, CT 06705 | 2014-03-05 |
| 1528403177 | Daniel G. Brennan | Dentist | 2457 East Main St, Waterbury, CT 06705 | 2013-05-08 |
| 1538419742 | Jenna Elizabeth Partola | Physician Assistant | 1327 Meriden Rd, Wolcott, CT 06705 | 2012-09-14 |
| 1710244785 | Mirta Sabino | Counselor | 126 Stonefield Dr, Waterbury, CT 06705 | 2012-04-16 |
| 1578849519 | Uday Shankar | Internal Medicine | 3801 E Main St Fl 2, Waterbury, CT 06705 | 2011-10-21 |
| Find all providers in zip 06705 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245261551 | David Goldwag | Emergency Medicine | 64 Robbins Street, Waterbury, CT 06708 | 2006-07-05 |
| 1598755753 | Robert E Murray IIi | Emergency Medicine | 64 Robbins St, Waterbury, CT 06708-2613 | 2005-10-27 |
| 1154951341 | Christina Devi Drelichowski | Emergency Medicine | 64 Robbins St, Waterbury, CT 06708-2600 | 2020-01-16 |
| 1003362351 | Peter Samir Hanna | Emergency Medicine | 64 Robbins St, Waterbury, CT 06708 | 2016-08-28 |
| 1821404591 | Gholamreza Sadeghipour Roodsari | Emergency Medicine | 56 Franklin St, Waterbury, CT 06706-1253 | 2014-07-02 |
| 1174866818 | Brian Jeffrey Steiner | Emergency Medicine | 64 Robbins St, Waterbury, CT 06708-2613 | 2013-04-01 |
| 1831444322 | Ct Colony Emergency Physicians, LLC | Emergency Medicine | 64 Robbins St, Waterbury, CT 06708-2613 | 2012-07-20 |
| 1164782652 | Christian Kakowski | Emergency Medicine | 56 Franklin St, Waterbury, CT 06706-1253 | 2012-05-18 |
| 1154635217 | Margaret Joan-claire Noonan | Emergency Medicine | 56 Franklin St, Dept of Em, Waterbury, CT 06706-1253 | 2010-07-31 |
| 1205065356 | Eudocia Antonia Cabello | Emergency Medicine | 56 Franklin St, Waterbury, CT 06706-1253 | 2009-07-10 |
| Find all providers in WATERBURY | ||||
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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.