DR. KIMBERLY C. RIQUELME (NPI# 1619282191) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1619282191 |
| Entity Type | Individual |
| Full Name | DR. KIMBERLY C. RIQUELME |
| Other Name | KIMBERLY C. SCHRECK |
| Credential | D.O. |
| Practice Address |
1353 Gold Star Hwy Groton CT 06340 |
| Mailing Address |
1353 Gold Star Hwy Groton CT 06340-2739 |
| Practice Telephone | 8604499947 |
| Mailing Telephone | 8604499947 |
| Enumeration Date | 2010-08-09 |
| Last Update Date | 2018-07-03 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
54151 | CT | Allopathic & Osteopathic Physicians |
| Y | 2084P0804X |
Psychiatry & Neurology Specialization: Child & Adolescent Psychiatry |
54151 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | LICENSE | 54151 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 5 Research Pkwy, Old Saybrook, CT 064754211 | 8605100163 | 8605100486 |
| Street Address |
1353 GOLD STAR HWY |
| City | GROTON |
| State | CT |
| Zip Code | 06340 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265428544 | Numan Gharaibeh | Psychiatry & Neurology | 1353 Gold Star Hwy, Groton, CT 06340-2739 | 2005-09-22 |
| 1609498526 | Rachel Skelton | Counselor | 1353 Gold Star Hwy, Groton, CT 06340-2739 | 2020-05-13 |
| 1063953156 | Sol Integrative Wellness, LLC | Physical Therapist | 1353 Gold Star Hwy, Suite 106, Groton, CT 06340-2739 | 2017-03-09 |
| 1861942211 | Point Therapy, LLC | Acupuncturist | 1353 Gold Star Hwy, Suite 106, Groton, CT 06340-2739 | 2016-10-10 |
| 1659705028 | Shawne L Baker | Social Worker | 1353 Gold Star Hwy, Groton, CT 06340-2739 | 2013-08-21 |
| 1457614190 | Sarah E Del Grosso | Counselor | 1353 Gold Star Hwy, Groton, CT 06340-2739 | 2012-06-18 |
| 1952692592 | Integrated Health and Performance LLC | Chiropractor | 1353 Gold Star Hwy, Suite 106, Groton, CT 06340-2739 | 2011-05-01 |
| 1154620037 | Tyler Curtis Page | Chiropractor | 1353 Gold Star Hwy, Groton, CT 06340-2739 | 2011-03-18 |
| 1073679569 | Edward E Hutter | Chiropractor | 1353 Gold Star Hwy, Ste 106, Groton, CT 06340-2755 | 2006-12-29 |
| 1487716866 | Christopher David Deveau | Chiropractor | 1353 Gold Star Hwy, Suite 106, Groton, CT 06340-2739 | 2006-12-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912558610 | Bruce Lancel Bernardo Lara | Military Health Care Provider | Fpo, Ae, 09587-2417, Groton, AE 06340 | 2019-09-24 |
| 1295393692 | Ermelinda Elaine Alviso | Military Health Care Provider | Trout Ave, Groton, CT 06340 | 2019-05-31 |
| 1679034011 | Derek James Hale | Military Health Care Provider | Fc 83 Numi, Trout Ave, Groton, CT 06340 | 2019-03-28 |
| 1063973790 | Cody Eugene Shaw | Military Health Care Provider | Numi, Trout Ave Building 83, Groton, CT 06340 | 2019-03-26 |
| 1265906911 | Homelife Companions and Homemakers, LLC | Adult Companion | 1 Fort Hill Road, Suite 3, Groton, CT 06340 | 2019-01-16 |
| 1144735457 | Kristina Marie Carta | Behavior Technician | 220 Rt 12, Suite 205, Groton, CT 06340 | 2017-12-08 |
| 1538674262 | Tercel Dental Pllc | Dentist | 643 Gold Star Hwy., Groton, CT 06340 | 2017-12-04 |
| 1306361662 | Stonington Behavioral Health Inc | Psychologist | 618 Poquonnock Rd, Groton, CT 06340 | 2017-08-08 |
| 1104347806 | Renae Reynolds | Optometrist | 489 Gold Star Hwy Ste 100, Groton, CT 06340 | 2017-07-03 |
| 1053831552 | Susan A Bradbury | Physical Therapist | 455 Eastern Point Rd, Groton, CT 06340 | 2017-06-26 |
| Find all providers in zip 06340 | ||||
| Taxonomy Code | 2084P0804X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Child & Adolescent Psychiatry |
| Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649667106 | Ayodola Adigun | Psychiatry & Neurology | 200 Broad St Apt 2214, Stamford, CT 06901-2070 | 2015-04-22 |
| 1801209952 | Oscar A Gerdner | Psychiatry & Neurology | 167 Old Post Rd, Southport, CT 06890-1395 | 2014-06-06 |
| 1194165720 | H and B Quality Medical Care LLC | Psychiatry & Neurology | 2 Ivy Brook Rd Ste 120, Shelton, CT 06484-6416 | 2013-06-27 |
| 1659710242 | Ibrahim N. Orgun | Psychiatry & Neurology | 44 Craigemore Cir, Avon, CT 06001-3417 | 2013-06-18 |
| 1588007314 | Avery Grauer | Psychiatry & Neurology | 175 Copse Road, Madison, CT 06443 | 2013-04-11 |
| 1972864627 | Sandra Boltax-stern, Md, PC | Psychiatry & Neurology | 78 Ansonia Road, Woodbridge, CT 06525 | 2012-05-30 |
| 1689972382 | Satwant Ahluwalia | Psychiatry & Neurology | 13 Woods Way, Redding, CT 06896-3200 | 2011-03-03 |
| 1962647842 | Pamela Edie Hoffman | Psychiatry & Neurology | 230 S Frontage Rd # G112, New Haven, CT 06519-1124 | 2008-12-08 |
| 1649423567 | Susan Jane Finkelstein | Psychiatry & Neurology | 3 Sylvan Road South, Westport, CT 06880 | 2008-10-23 |
| 1205083359 | Robert Khalil | Psychiatry & Neurology | 7 Old Sherman Tpke Ste 102, Danbury, CT 06810-4174 | 2008-08-20 |
| Find all providers with the same taxonomy | ||||
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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.