CONNECTICUT ADDICTION MEDICINE, LLC (NPI# 1710312368) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710312368 |
| Entity Type | Organization |
| Organization Name | CONNECTICUT ADDICTION MEDICINE, LLC |
| Other Organization Name | CONNECTICUT ADDICTION MEDICINE |
| Practice Address |
546 Cromwell Ave Suite 101 Rocky Hill CT 06067-1800 |
| Practice Telephone | 8607573874 |
| Practice Fax Number | 8607573875 |
| Mailing Telephone | 8607573874 |
| Mailing Fax Number | 8607573875 |
| Enumeration Date | 2013-09-13 |
| Last Update Date | 2017-04-19 |
| Authorized Official Name | TIFFANY INGOLD (OFFICE MANAGER) |
| Authorized Official Telephone | 8609691101 |
| Authorized Official Credential | OFFICE MANAGER |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 106H00000X | Marriage & Family Therapist | Behavioral Health & Social Service Providers | ||
| N | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 364SP0808X |
Clinical Nurse Specialist Specialization: Psych/Mental Health |
Physician Assistants & Advanced Practice Nursing Providers | ||
| N | 2084A0401X |
Psychiatry & Neurology Specialization: Addiction Medicine |
Allopathic & Osteopathic Physicians | ||
| N | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
CT | Physician Assistants & Advanced Practice Nursing Providers | |
| Y | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
Allopathic & Osteopathic Physicians | ||
| N | 291U00000X | Clinical Medical Laboratory | CLPOL0509 | CT | Laboratories |
| Other Name | Type Code |
|---|---|
| Connecticut Addiction Medicine | Doing Business As Name - Organization |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | CONNECTICUT ADDICTION MEDICINE, LLC | 178 Riverknolls, Avon, CT 06001 |
| Street Address |
546 CROMWELL AVE SUITE 101 |
| City | ROCKY HILL |
| State | CT |
| Zip Code | 06067-1800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326016726 | Edith Hergan | Anesthesiology | 546 Cromwell Ave, Suite 101, Rocky Hill, CT 06067-1800 | 2006-03-10 |
| 1568642346 | Rocky Hill Pediatrics, LLC | Pediatrics | 546 Cromwell Ave, Rocky Hill, CT 06067-1800 | 2007-11-08 |
| 1841481579 | Brian James Riley | Obstetrics & Gynecology | 546 Cromwell Ave, Suite 100, Rocky Hill, CT 06067-1800 | 2007-08-07 |
| 1801094479 | Mahboob Ahmad Aslam | Psychiatry & Neurology | 546 Cromwell Ave, Suite 101, Rocky Hill, CT 06067-1800 | 2007-07-05 |
| 1407979982 | Kathryn E Litwin | Pediatrics | 546 Cromwell Ave, Rocky Hill, CT 06067-1800 | 2007-04-09 |
| 1417052655 | Elizabeth C Winkler | Nurse Practitioner | 546 Cromwell Ave, Rocky Hill, CT 06067-1800 | 2006-09-13 |
| 1285642611 | Robert Dariusz Bogacki | Internal Medicine | 546 Cromwell Ave, Suite 201, Rocky Hill, CT 06067-1857 | 2006-08-03 |
| 1720017056 | Jay B Benson | Family Medicine | 546 Cromwell Ave, Suite 101, Rocky Hill, CT 06067-1800 | 2006-06-30 |
| 1063464311 | Jennifer Lindwall Schwab | Pediatrics | 546 Cromwell Ave, Rocky Hill, CT 06067 | 2006-05-16 |
| 1972555225 | John Joseph Fote | Pediatrics | 546 Cromwell Ave, Rocky Hill, CT 06067 | 2006-05-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164924643 | Myeyedr Optometry of Connecticut, LLC | Optometrist | 2162 Silas Dean Highway, Rocky Hill, CT 06067 | 2018-03-01 |
| 1285049304 | Edmund Swan | Optometrist | 38 Town Line Rd, Rocky Hill, CT 06067 | 2014-06-26 |
| 1962814145 | Touchpoints Homecare, LLC | Home Health | 1838 Silas Deane Hwy, Rocky Hill, CT 06067 | 2014-05-22 |
| 1649696014 | Janet Kelly | Speech-Language Pathologist | 135 Old Main Street, Rocky Hill, CT 06067 | 2014-03-10 |
| 1194147256 | George Ginsberg | Dentist | 35 Cold Spring Rd, Suite 325, Rocky Hill, CT 06067 | 2014-01-09 |
| 1679901953 | Masters In Home Care, LLC | Home Health | 40 Cold Spring Rd, Rocky Hill, CT 06067 | 2013-10-23 |
| 1154661783 | Kelly Marie Carlson | Pharmacy Technician | 30 Cold Springs Road, Rockyhill, CT 06067 | 2013-02-19 |
| 1851631683 | Tia Jean Williams | Physician Assistant | 1111 Cromwell Ave # 404, Rocky Hill, CT 06067 | 2013-02-14 |
| 1700125804 | Marisol Rodriguez | Reflexologist | 1800 Silas Deane Highway, Suite 150, Rocky Hill, CT 06067 | 2013-02-08 |
| 1790070530 | Kelly A Cronin | Nurse Practitioner | 500 Enterprise Drive, Suite 4a, Rocky Hill, CT 06067 | 2011-06-09 |
| Find all providers in zip 06067 | ||||
| Taxonomy Code | 2084P0802X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Addiction Psychiatry |
| Addiction Psychiatry is a subspecialty of psychiatry that focuses on evaluation and treatment of individuals with alcohol, drug, or other substance-related disorders, and of individuals with dual diagnosis of substance-related and other psychiatric disorders. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811426695 | Fairfield County Health & Wellness Services II LLC | Psychiatry & Neurology | 325 Reef Road/suite 109, Fairfield, CT 06824 | 2017-06-06 |
| 1154583748 | Zinaida Boutaeva | Psychiatry & Neurology | 6232 Avalon Dr W, Orange, CT 06477-3679 | 2008-06-25 |
| 1144406802 | Shanthi Mogali | Psychiatry & Neurology | 187 S Canaan Rd, Canaan, CT 06018-2544 | 2008-01-11 |
| 1669402343 | Jean Carl Jarda | Psychiatry & Neurology | 28-2 Shunpike Rd, Cromwell, CT 06416 | 2006-07-05 |
| 1336124676 | Yuencheng Han | Psychiatry & Neurology | 750 Straits Tpke, Middlebury, CT 06762-2833 | 2005-12-09 |
| 1831647957 | Straun Health & Wellness | Psychiatry & Neurology | 1224 Mill St, Bldg B, East Berlin, CT 06023-1159 | 2016-09-18 |
| 1528444346 | Marie-josee A. Lynch | Psychiatry & Neurology | 950 Campbell Ave, West Haven, CT 06516-2770 | 2015-08-04 |
| 1215367081 | Gengyun Wen | Psychiatry & Neurology | 189 Storrs Rd, Natchaug Hospital, Mansfield Center, CT 06250-1683 | 2013-11-15 |
| 1043560287 | Michael Kofi Adusei | Psychiatry & Neurology | 30 Shelburne Rd, Stamford Hospital, Stamford, CT 06902 | 2012-09-14 |
| 1023370186 | Maria Ghanbari Motlagh | Psychiatry & Neurology | 20 York St # T-209, Yale-new Haven Hospital, New Haven, CT 06510-3220 | 2012-06-13 |
| Find all providers with the same taxonomy | ||||
| City | ROCKY HILL |
| Zip Code | 06067 |
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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.