DR. DEEPA CAMENGA (NPI# 1952318214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952318214 |
| Entity Type | Individual |
| Full Name | DR. DEEPA CAMENGA |
| Other Name | DEEPA PRASAD |
| Credential | MD |
| Practice Address |
20 York St New Haven CT 06510-3220 |
| Mailing Address |
464 Congress Ave Ste 260 New Haven CT 06519-1362 |
| Practice Telephone | 2036885555 |
| Mailing Telephone | 2037378310 |
| Mailing Fax Number | 2037853461 |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2019-01-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RA0401X |
Internal Medicine Specialization: Addiction Medicine |
47964 | CT | Allopathic & Osteopathic Physicians |
| N | 208000000X | Pediatrics | 47964 | CT | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | APT FOUNDATION MEDICAID | 008003745 | 01 |
| CT | APT FOUNDATION MEDICAID | 004217099 | 01 |
| CT | 008040283 | 05 | |
| CT | APT FOUNDATION MEDICAID | 004041000 | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1 Long Wharf Dr, New Haven, CT 065115991 | 2037814600 | 2037814624 |
| Street Address |
20 YORK ST |
| City | NEW HAVEN |
| State | CT |
| Zip Code | 06510-3220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376547042 | Kimberly C Irwin | Specialist | 20 York St, New Haven, CT 06510-3220 | 2005-06-09 |
| 1225639644 | Lauren Marie Astorino | Nurse Practitioner | 20 York St, New Haven, CT 06510-3220 | 2020-11-03 |
| 1598365215 | Apphia Rose Harris | Nurse Practitioner | 20 York St, New Haven, CT 06510-3220 | 2020-10-30 |
| 1861091365 | Melissa Todice | Nurse Practitioner | 20 York St, New Haven, CT 06510-3220 | 2020-10-26 |
| 1528665213 | Rebecca Dorothy Harrison | Nurse Practitioner | 20 York St, New Haven, CT 06510-3220 | 2020-10-06 |
| 1467068551 | Marissa Meegan Sanca | Registered Nurse | 20 York St, New Haven, CT 06510-3220 | 2020-09-23 |
| 1093321234 | Oksana Petsukh | Nurse Practitioner | 20 York St, New Haven, CT 06510-3220 | 2020-09-22 |
| 1841806114 | Madiha Shah | Pharmacist | 20 York St, New Haven, CT 06510-3220 | 2020-09-21 |
| 1053926303 | Tanyeri Barak | Student in an Organized Health Care Education/Training Program | 20 York St, Tompkins 226, New Haven, CT 06510-3220 | 2020-09-14 |
| 1548875776 | Lisa Wrubel | Registered Nurse | 20 York St, New Haven, CT 06510-3220 | 2020-09-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336757319 | Matthew Peter O'connell | Pharmacist | 55 Park Street, Lower Level, Department of Pharmacy, New Haven, CT 06510 | 2020-07-16 |
| 1477171460 | Huy Henry Le | Pharmacist | 20 York Street, Ps-ll, New Haven, CT 06510 | 2020-07-07 |
| 1144855263 | Daniel Jacobs | Student in an Organized Health Care Education/Training Program | 367 Cedar Street, Bldg. D, Student Affairs Office, New Haven, CT 06510 | 2020-03-09 |
| 1346898467 | Cem Cengiz | Internal Medicine | Tobb Etu Hastanesi, Yasam Cad. No.5 Sogutozu, Ankara, TURKEY 06510 | 2019-09-02 |
| 1295292290 | Emily Elizabeth Samuel | Counselor | 40 Temple Street, Ste 7c, Yale Child Outpatient Clinic, New Haven, CT 06510 | 2019-02-26 |
| 1639652779 | Laura Goldblum | Social Worker | 1450 Chapel Childrens Hospital, 1450 Chapel Street, New Haven, CT 06510 | 2018-09-14 |
| 1477049138 | Joseph Lawrence Earles | Otolaryngology | Yale Physicians Building, 800 Howard Ave., 4th Floor, New Haven, CT 06510 | 2018-07-06 |
| 1508356759 | Rebecca Anne Beagan | Student in an Organized Health Care Education/Training Program | 20 York Street- Pediatrics, New Haven, CT 06510 | 2018-05-14 |
| 1104316405 | Emma Sophie Taylor-salmon | Student in an Organized Health Care Education/Training Program | 20 York Street - Pediatrics, New Haven, CT 06510 | 2018-05-14 |
| 1376033563 | Wael S Ibrahim | Student in an Organized Health Care Education/Training Program | 20 York Street, Ynnh - Tompkins 226, New Haven, CT 06510 | 2018-05-14 |
| Find all providers in zip 06510 | ||||
| Taxonomy Code | 207RA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Addiction Medicine |
| An internist doctor of osteopathy that specializes in the treatment of addiction disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Added Qualifications in the field of Addiction Medicine. |
| Notes: Source: American Osteopathic Board of Internal Medicine, 2007. [7/1/2008: added definition, added source; 7/1/2011: modified source] - Additional Resources: http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891889010 | Bridget Ann Martell | Internal Medicine | 20 York St., Yale University Section of General Internal Medicine, New Haven, CT 06520 | 2006-10-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922215821 | Luke E O'connor | Internal Medicine | 23 Ellington Ave, Po 878 Willimantic Ct 06022, Ellington, CT 06029 | 2007-05-17 |
| 1962797696 | Genevieve Montagu Von Walstrom | Internal Medicine | 17 Wall St, Madison, CT 06443-3122 | 2011-06-10 |
| 1801103858 | Richard N. Goldberg Md, PC | Internal Medicine | 211 New Britain Rd, Suite 206, Kensington, CT 06037 | 2010-09-10 |
| 1376618611 | Ebenezer Kolade | Internal Medicine | 3851 Main St, Bridgeport, CT 06606-2864 | 2006-11-22 |
| 1659340651 | Nermina Bukalo | Internal Medicine | 71 Haynes St, Manchester, CT 06040-4131 | 2006-03-14 |
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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.