PREMIER MEDICAL ASSOCIATES (NPI# 1710948443) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710948443 |
| Entity Type | Organization |
| Organization Name | PREMIER MEDICAL ASSOCIATES |
| Practice Address |
929 Boston Post Rd Old Saybrook CT 06475-2143 |
| Practice Telephone | 8603881115 |
| Mailing Telephone | 8603881115 |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DR. STEVEN ANTHONY GAUDIO (MANAGING PARTNER) |
| Authorized Official Telephone | 8603881115 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| X | 207ND0900X |
Dermatology Specialization: Dermatopathology |
26345 | CT | Allopathic & Osteopathic Physicians |
| X | 207R00000X | Internal Medicine | 26345 | CT | Allopathic & Osteopathic Physicians |
| X | 207R00000X | Internal Medicine | 042317 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | BLUE CROSS | 50PREMIERCT01 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154836500 | Premier Medical Associates | Psychiatry & Neurology | 20930 Dupont Blvd Unit 202, Georgetown, DE 19947-1724 | 2017-12-07 |
| 1942740097 | Premier Medical Associates | Counselor | 231 Crosswicks Rd, Suite 11, Bordentown, NJ 08505-2602 | 2017-03-07 |
| 1366656456 | Premier Medical Associates | General Practice | 422 Worcester St, Suite 105, Wellesley, MA 02481-5341 | 2007-05-09 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Indiana Business Entities | PREMIER MEDICAL ASSOCIATES OF INDIANA, P.S.C., INC. | 3200 Burnet Ave., Cincinnati, OH 45229 |
| Street Address |
929 BOSTON POST RD |
| City | OLD SAYBROOK |
| State | CT |
| Zip Code | 06475-2143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528248739 | Shoreline Digestive Health Center | Specialist | 929 Boston Post Rd, Old Saybrook, CT 06475-2143 | 2007-11-06 |
| 1427273747 | Colin Morris | Physical Therapist | 929 Boston Post Rd, Old Saybrook, CT 06475-2143 | 2007-04-13 |
| 1699893099 | Armen G Ketchedjian | Anesthesiology | 929 Boston Post Rd, Suite 1, Old Saybrook, CT 06475-2143 | 2007-03-26 |
| 1992857130 | Robert Joseph Gassman | Dietitian, Registered | 929 Boston Post Rd, Old Saybrook, CT 06475-2143 | 2007-01-17 |
| 1639227259 | George L Lynn | Psychologist | 929 Boston Post Rd, Old Saybrook, CT 06475 | 2007-01-08 |
| 1851472054 | East Coast Anesthesia | Anesthesiology | 929 Boston Post Rd, Suite 1, Old Saybrook, CT 06475-2143 | 2006-10-17 |
| 1487673133 | Sean Mitchell Kennedy | Specialist/Technologist | 929 Boston Post Rd, Old Saybrook, CT 06475-2143 | 2006-07-19 |
| 1245264258 | Maurizio Domenico Nichele | Surgery | 929 Boston Post Rd, Suite 1, Old Saybrook, CT 06475-2143 | 2006-07-10 |
| 1689608697 | Advanced Colon Care Inc | Clinic/Center | 929 Boston Post Rd, Suite 1, Old Saybrook, CT 06475-2143 | 2006-07-10 |
| 1356303671 | Steven Anthony Gaudio | Dermatology | 929 Boston Post Rd, Old Saybrook, CT 06475-2143 | 2006-04-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912464223 | Kathleen Malcolm | Physical Medicine & Rehabilitation | Apple Rehab Saybrook, 1775 Boston Post Rd, Old Saybrook, CT 06475 | 2019-02-22 |
| 1841661469 | Laura M. Shires, Lcsw, LLC | Social Worker | 24 Ledge Road, Old Saybrook, CT 06475 | 2015-10-08 |
| 1316323397 | Robyn Reilly | Nurse Practitioner | 1687 Rte 1, Old Saybrook, CT 06475 | 2015-08-03 |
| 1679858542 | Brandi Taylor | Counselor | 263 Main St., Suite 301, Old Saybrook, CT 06475 | 2011-10-11 |
| 1346545670 | Lucille Wymer Hartman | Mechanotherapist | 1775 Boston Post Road, Old Saybrook, CT 06475 | 2011-01-18 |
| 1508160631 | Whole Health Wellness, LLC | Clinic/Center | 139 Mill Rock Rd E Unit 1522, Old Saybrook, CT 06475 | 2011-01-04 |
| 1184948481 | Maria S. Foss-rand | Counselor | 251 Main St., Suite 100, Old Seybrook, CT 06475 | 2010-03-16 |
| 1467658161 | Rick Morant Dmd Ms LLC | Dentist | 1358 Boston Post Rd, Suite 2, Old Saybrook, CT 06475 | 2007-06-21 |
| 1174724801 | Richard P Benoit Dmd PC | Dentist | 123 Elm Street, Suite 1300, Old Saybrook, CT 06475 | 2007-05-30 |
| 1194932392 | Omotayo Elizabeth Awujoola | Nurse Practitioner | 20 Research Parkway, Old Saybrook, CT 06475 | 2007-05-17 |
| Find all providers in zip 06475 | ||||
| Taxonomy Code | 207ND0900X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Dermatology |
| Specialization | Dermatopathology |
| A dermatopathologist has the expertise to diagnose and monitor diseases of the skin including infectious, immunologic, degenerative and neoplastic diseases. This entails the examination and interpretation of specially prepared tissue sections, cellular scrapings and smears of skin lesions by means of routine and special (electron and fluorescent) microscopes. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Dermatology, 2007. http://www.abderm.org/; American Osteopathic Board of Dermatology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Dermatology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Dermatology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356303671 | Steven Anthony Gaudio | Dermatology | 929 Boston Post Rd, Old Saybrook, CT 06475-2143 | 2006-04-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346658978 | Cutaneous Pathology Associates, LLC | Dermatology | 6 Forest Park Dr, Farmington, CT 06032-1480 | 2014-07-28 |
| 1760827166 | Cohen Dermatopathology, PC | Dermatology | 270 Farmington Ave, Suite 332, Farmington, CT 06032-1934 | 2013-04-30 |
| 1770776569 | Dermatology In Clinton, LLP | Dermatology | 8 E Main St, Suite 101, Clinton, CT 06413-2058 | 2007-08-24 |
| 1639380884 | Katalin Ferenczi | Dermatology | 21 South Rd, Dermatology, Farmington, CT 06032-2410 | 2007-05-26 |
| 1154538122 | Arni Kjalar Kristjansson | Dermatology | 21 South Rd, Farmington, CT 06032-2482 | 2007-05-17 |
| 1558403311 | Soheil S Dadras | Dermatology | 21 South Rd, Dermatopathology Lab, Farmington, CT 06032-2482 | 2007-02-12 |
| 1780681122 | Michael J. Murphy | Dermatology | 263 Farmington Ave, Farmington, CT 06030-0001 | 2005-06-30 |
| 1114922879 | Adrienne B Berke | Dermatology | 21 South Rd, Dermatoloty, Farmington, CT 06032-2482 | 2005-06-17 |
| City | OLD SAYBROOK |
| Zip Code | 06475 |
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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.