DR. DECIO MACEDA DE ESCOBAR (NPI# 1407875669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407875669 |
| Entity Type | Individual |
| Full Name | DR. DECIO MACEDA DE ESCOBAR |
| Credential | M.D. |
| Practice Address |
171 Grandview Ave Suite 202 Waterbury CT 06708-2517 |
| Practice Telephone | 2037579336 |
| Practice Fax Number | 2037579611 |
| Mailing Telephone | 2037579336 |
| Mailing Fax Number | 2037579611 |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207YX0602X |
Otolaryngology Specialization: Otolaryngic Allergy |
12669 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | HEALTHNET | 0V0638 | 01 |
| CT | BLUECROSS | 010012669CT01 | 01 |
| CT | 001126697 | 05 | |
| CT | CONNECTICARE | 706416 | 01 |
| Street Address |
171 GRANDVIEW AVE SUITE 202 |
| City | WATERBURY |
| State | CT |
| Zip Code | 06708-2517 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720083421 | Raymond E Winicki | Otolaryngology | 171 Grandview Ave, Ste 201, Waterbury, CT 06708-2520 | 2005-06-17 |
| 1699212704 | Gcnt LLC | Emergency Medicine | 171 Grandview Ave, Ste 105, Waterbury, CT 06708-2517 | 2017-01-26 |
| 1538544481 | Caitlin Cann | Audiologist | 171 Grandview Ave, Suite 201, Waterbury, CT 06708-2517 | 2015-07-21 |
| 1376958876 | Ankur Talati | Student in an Organized Health Care Education/Training Program | 171 Grandview Ave, Suite 103, Waterbury, CT 06708-2517 | 2014-06-24 |
| 1386931277 | Dr. Decio M. De Escobar | Naturopath | 171 Grandview Ave, Suite 101, Waterbury, CT 06708-2517 | 2011-06-30 |
| 1881987964 | Ct Dental LLC | Dentist | 171 Grandview Ave, Suite 103, Waterbury, CT 06708-2517 | 2011-05-23 |
| 1174836134 | Tulasi N Vikram | Dentist | 171 Grandview Ave, Suite 103, Waterbury, CT 06708-2517 | 2010-07-20 |
| 1063668200 | Cheryl Lynn Lyon | Naturopath | 171 Grandview Ave, Suite 202, Waterbury, CT 06708-2517 | 2008-08-07 |
| 1427230804 | Deann Masterson | Physician Assistant | 171 Grandview Ave, Suite 201, Waterbury, CT 06708-2517 | 2007-11-28 |
| 1447430467 | Waterbury Podiatry Consultants | Podiatrist | 171 Grandview Ave, Suite 104, Waterbury, CT 06708-2517 | 2007-11-07 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952864787 | Sidhant Singh | Student in an Organized Health Care Education/Training Program | Chase Outpatient Center,160 Robbins Street, Waterbury, CT 06708 | 2019-04-09 |
| 1023574753 | Santa Maria & Schneider D.m.d Waterbury LLC | Dentist | 276 Highland Ave., Waterbury, CT 06708 | 2019-02-19 |
| 1548766959 | Caroline Johnssen | Student in an Organized Health Care Education/Training Program | Chase Outpatient Center, 160 Robbins Street, Waterbury, CT 06708 | 2018-04-04 |
| 1992209530 | Valley Wellness Consulting Group LLC | Social Worker | 969 W Main Street, Suite 3e, Waterbury, CT 06708 | 2018-03-20 |
| 1306346457 | C&s Family Dental Waterbury, LLC | Dentist | 1630 Watertown Ave, Waterbury, CT 06708 | 2018-02-15 |
| 1447759865 | Inurse Homecare, LLC. | Home Health | 140 Fulkerson Drive Unit 2c, Waterbury, CT 06708 | 2018-02-12 |
| 1619423977 | Robert Girard II | Counselor | 969 West Main Street, Suite 1 D, Waterbury, CT 06708 | 2016-08-28 |
| 1457734360 | Alternatives, Inc. | Intermediate Care Facility, Mentally Retarded | 148 Highview St, Waterbury, CT 06708 | 2015-07-09 |
| 1407266901 | Maria Munoz | Obstetrics & Gynecology | 140 Grandview Ave Ste 202, Waterbury, CT 06708 | 2014-05-06 |
| 1922420330 | Danielle Moraes | Social Worker | 276 Highland Av 2nd Fl North, Waterbury, CT 06708 | 2014-01-21 |
| Find all providers in zip 06708 | ||||
| Taxonomy Code | 207YX0602X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Otolaryngology |
| Specialization | Otolaryngic Allergy |
| An otolaryngologist who specializes in the diagnosis and treatment of otolaryngic allergies and other allergic diseases. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) is issued by the American Osteopathic Board of Ophthalmology and Otolaryngology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881841872 | Litchfield County Ear Nose & Throat PC | Otolaryngology | 146 Danbury Rd, New Milford, CT 06776-3427 | 2008-08-21 |
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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.