NORWICH INFECTIOUS DISEASE ASSOCIATES LLC (NPI# 1730332313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730332313 |
| Entity Type | Organization |
| Organization Name | NORWICH INFECTIOUS DISEASE ASSOCIATES LLC |
| Practice Address |
112 Lafayette St Norwich CT 06360-2737 |
| Practice Telephone | 8608868545 |
| Practice Fax Number | 8556297856 |
| Mailing Telephone | 8608868545 |
| Mailing Fax Number | 8556297856 |
| Enumeration Date | 2008-10-28 |
| Last Update Date | 2014-10-03 |
| Authorized Official Name | MICHAEL J RAJKUMAR (PRESIDENT) |
| Authorized Official Telephone | 8608868545 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | I17254 | CT | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | 001386607 | 05 | |
| CT | AETNA | 1730332313 | 01 |
| CT | CIGNA | 9621008 | 01 |
| CT | ANTHEM | 010038660CT02 | 01 |
| Street Address |
112 LAFAYETTE ST |
| City | NORWICH |
| State | CT |
| Zip Code | 06360-2737 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689651143 | Michael J Rajkumar | Internal Medicine | 112 Lafayette St, Norwich, CT 06360-2737 | 2005-12-27 |
| 1821431008 | M. Krista Mikkelson | Pharmacist | 112 Lafayette St, Norwich, CT 06360-2737 | 2013-04-08 |
| 1922299098 | Vinod V Pathy | Plastic Surgery | 112 Lafayette St, Norwich, CT 06360-2737 | 2007-08-05 |
| 1487669081 | Utley & Jones Pharmacy Inc | Pharmacy | 112 Lafayette St, Norwich, CT 06360-2776 | 2006-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003417452 | Mafe Duyan Rato | Nurse Practitioner | 624 W West Main St, St 140, Norwich, CT 06360 | 2020-11-03 |
| 1255961561 | Holly M. Renstrom | Driver | 17 Annadell Rd, Norwich, CT 06360 | 2020-01-26 |
| 1609335397 | Chanel Justice | Social Worker | 2 Clinic Drive, Outpatient Clinic for Children, Norwich, CT 06360 | 2019-03-13 |
| 1457700189 | Michelle Pressler | Pharmacist | 634 West Main St, Norwich, CT 06360 | 2016-06-03 |
| 1265895726 | Katie Johnson | Social Worker | 18 Oneco Street, Norwich, CT 06360 | 2016-04-01 |
| 1871956623 | Lori Deslandes-paz | Pharmacist | 372 West Main Street, Norwich, CT 06360 | 2016-03-30 |
| 1336526193 | Keep An Open Mind, LLC | Marriage & Family Therapist | 12 Cass Street, Suite 202, Norwich, DC 06360 | 2015-04-30 |
| 1588084446 | Kinneri Kothari | Ophthalmology | 79 Wawecus St Ste 105, Norwich, CT 06360 | 2014-04-18 |
| 1962746537 | Robin B Smith | Social Worker | 401 W. Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-20 |
| 1063766400 | Colleen Ellen Phillips-white | Social Worker | 401 West Thames St, Bldg 301, Southeastern Mental Health Authority, Norwich, CT 06360 | 2012-11-07 |
| Find all providers in zip 06360 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154763027 | James Matthew Herzog | Specialist | 109 Thompson Creek Rd, Norwich, NY 13815-3543 | 2013-07-22 |
| 1144584459 | Mary Carson | Specialist | 79 S Broad St, Norwich, NY 13815-1741 | 2012-07-02 |
| 1013278175 | Dawn S Hagenbuch | Specialist | 5456 State Highway 23, Norwich, NY 13815-3142 | 2012-06-06 |
| 1568474484 | Steven K Gamble | Specialist | 7 Clinic Drive, Norwich, CT 06360-2915 | 2006-08-12 |
| 1396701256 | Robert - Kerrigan | Specialist | 60 Mediterranean Ln, Norwich, CT 06360-1648 | 2006-04-20 |
| 1821064379 | Norwich Pathology Consultants, P.C. | Specialist | 120 Lafayette St, Suite 213, Norwich, CT 06360-2717 | 2006-02-24 |
| 1992784797 | Seco Physical & Occupational Therapy Pllc | Specialist | 6110 Co Rt 32, Norwich, NY 13815-1046 | 2006-01-11 |
| 1427485499 | Kim Mauro | Specialist | 7 Clinic Dr, Norwich, CT 06360-2915 | 2013-10-04 |
| 1346578978 | K Stephens Taylor Md PC | Specialist | 57 Lafayette St, Norwich, CT 06360-3407 | 2009-11-19 |
| 1043488059 | Orthopedic Physical Therapy of Southern New England LLC | Specialist | 7 Clinic Dr, Norwich, CT 06360-2915 | 2008-02-12 |
| Find all providers in NORWICH | ||||
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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.