CARDIOMED OF CONNECTICUT, LLC (NPI# 1699964403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699964403 |
| Entity Type | Organization |
| Organization Name | CARDIOMED OF CONNECTICUT, LLC |
| Practice Address |
4695 Main St Suite 19 Bridgeport CT 06606-1802 |
| Practice Telephone | 2033715189 |
| Practice Fax Number | 2033726365 |
| Mailing Telephone | 2033715189 |
| Mailing Fax Number | 2033726365 |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2014-05-08 |
| Authorized Official Name | DR. MOHUMMAD RAZA (OWNER) |
| Authorized Official Telephone | 2033715189 |
| Authorized Official Credential | M.D., F.A.C.C |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0000X |
Internal Medicine Specialization: Cardiovascular Disease |
036793 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 001367938 | 05 |
| Street Address |
4695 MAIN ST SUITE 19 |
| City | BRIDGEPORT |
| State | CT |
| Zip Code | 06606-1802 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750375549 | Jeffrey Daniel Small | Urology | 4695 Main St, Bridgeport, CT 06606-1802 | 2005-09-07 |
| 1407106735 | Sne Asc II LLC | Clinic/Center | 4695 Main St, Bridgeport, CT 06606-1802 | 2012-09-13 |
| 1740519883 | Dr. Jeffrey Small | Specialist | 4695 Main St, Bridgeport, CT 06606-1802 | 2009-12-21 |
| 1043498009 | Howard W Harinstein | Podiatrist | 4695 Main St, Suite 15, Bridgeport, CT 06606-1802 | 2008-02-01 |
| 1861678062 | Richard Combden | Optometrist | 4695 Main St, Bridgeport, CT 06606-1802 | 2008-01-17 |
| 1932252913 | Kenneth Feuerberg | Dentist | 4695 Main St, Bridgeport, CT 06606-1802 | 2007-01-21 |
| 1588717771 | Alan H. Liebnick | Dentist | 4695 Main St, Bridgeport, CT 06606-1802 | 2007-01-19 |
| 1114956992 | Ann Mary Carone | Optometrist | 4695 Main St, Bridgeport, CT 06606-1802 | 2006-07-02 |
| 1376570903 | Robert S. Feuerberg | Dentist | 4695 Main St, Bridgeport, CT 06606-1802 | 2006-06-27 |
| 1295771848 | Stephen Dean Breda | Otolaryngology | 4695 Main St, Suite 1, Bridgeport, CT 06606-1802 | 2006-06-21 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962023408 | Madeline Acquilano | Pharmacist | 2800 East Main St, Bridgeport, CT 06606 | 2020-05-06 |
| 1578192001 | Karin Alexandra Skalina | Student in an Organized Health Care Education/Training Program | 2800 Main St., Dept. of Medicine, Bridgeport, CT 06606 | 2020-04-06 |
| 1720641293 | Valeriia Klymenko | Student in an Organized Health Care Education/Training Program | 2800 Main Street, Department of Medicine, Bridgeport, CT 06606 | 2019-04-19 |
| 1821579996 | Ashley Liese | Nurse Practitioner | Cardiology Physicians of Fairfield County, 2679 Main St, Bridgeport, CT 06606 | 2018-08-27 |
| 1699261289 | Gema Estefania Giler-sacoto | Student in an Organized Health Care Education/Training Program | St. Vincent's Medical Center, 2800 Main Street, Department of Medicine, Bridgeport, CT 06606 | 2018-07-06 |
| 1114418365 | Jona Bumci | Physician Assistant | 3180 Main St Ste 304, Bridgeport, CT 06606 | 2018-05-23 |
| 1023471299 | Qmg4, LLC | Family Medicine | 4200 Main Street, Bridgeport, CT 06606 | 2016-04-04 |
| 1861867442 | Marie Dorothea Lisieski | Social Worker | 2400 Main Street, Bridgeport, CT 06606 | 2015-12-08 |
| 1548603384 | Gerald E. Hedley | Internal Medicine | 390 Charles Street Unit #101, Bridgeport, CT 06606 | 2013-04-11 |
| 1487997581 | Gerald Micalizzi, M.d., LLC | Radiology | 558 Fairview Avenue, Bridgeport, CT 06606 | 2013-03-27 |
| Find all providers in zip 06606 | ||||
| Taxonomy Code | 207RC0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Cardiovascular Disease |
| An internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2008 [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, http://www.abim.org/. American Osteopathic Board of Internal Medicine, https://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 |
|---|---|---|---|---|
| 1043713456 | United Hospital Center, Inc. | Internal Medicine | 527 Medical Park Dr Ste 106, Bridgeport, WV 26330-9009 | 2018-03-12 |
| 1033367743 | Mobile Cv Imaging, LLC | Internal Medicine | 136 Grovers Ave, Bridgeport, CT 06605-3536 | 2008-09-05 |
| 1073680393 | Abdul Rahim Khan | Internal Medicine | 285 Anton Dr, Bridgeport, CT 06606-1748 | 2006-11-30 |
| 1376595702 | David H Church | Internal Medicine | 527 Medical Park Dr Ste 304, Bridgeport, WV 26330 | 2006-05-16 |
| 1760440663 | Harry Bishop | Internal Medicine | 147 W Main St, Bridgeport, WV 26330-1866 | 2006-05-02 |
| 1598761512 | Joseph A Rose | Internal Medicine | 2979 Main St, Bridgeport, CT 06606-4252 | 2005-06-23 |
| 1437780020 | Poudre Valley Medical Group, LLC | Internal Medicine | 1313 S St, Bridgeport, NE 69336-2563 | 2020-02-01 |
| 1144731464 | Heart Health Clinic Pllc | Internal Medicine | 808 Woodrow Wilson Ray Cir, Bridgeport, TX 76426-2061 | 2017-10-13 |
| 1750768149 | Clarksburg Cardiovascular Pllc | Internal Medicine | 527 Medical Park Dr, Ste 306-a, Bridgeport, WV 26330-9008 | 2015-05-05 |
| 1699909432 | Anja Wagner | Internal Medicine | 2979 Main St, Bridgeport, CT 06606-4284 | 2009-05-07 |
| Find all providers in BRIDGEPORT | ||||
| City | BRIDGEPORT |
| Zip Code | 06606 |
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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.