DIGESTIVE DISEASE ASSOCIATES ENDOSCOPY SUITE, LLC (NPI# 1972758183) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1972758183 |
| Entity Type | Organization |
| Organization Name | DIGESTIVE DISEASE ASSOCIATES ENDOSCOPY SUITE, LLC |
| Practice Address |
229 Montowese St Branford CT 06405-3828 |
| Practice Telephone | 2034810315 |
| Practice Fax Number | 2034886945 |
| Mailing Telephone | 2034810315 |
| Mailing Fax Number | 2034886945 |
| Enumeration Date | 2008-12-02 |
| Last Update Date | 2017-11-02 |
| Authorized Official Name | CHRISTOPHER DUNBAR ILLICK (PARTNER) |
| Authorized Official Telephone | 2034810315 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QA1903X |
Clinic/Center Specialization: Ambulatory Surgical |
0322 | CT | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | CCN CENTERS FOR MEDICARE AND MEDICAID SERVICES CERTIFICATION NUM | 07C0001054 | 01 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Connecticut Business Registrations | DIGESTIVE DISEASE ASSOCIATES ENDOSCOPY SUITE, LLC | 229 Montowese Street, Branford, CT 06405 |
| Street Address |
229 MONTOWESE ST |
| City | BRANFORD |
| State | CT |
| Zip Code | 06405-3828 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346209046 | Joseph Yu | Internal Medicine | 229 Montowese St, Branford, CT 06405-2821 | 2006-03-21 |
| 1164658555 | Michael Phillip Dorfman | Internal Medicine | 229 Montowese St, Branford, CT 06405-3828 | 2009-05-31 |
| 1427292614 | Keri Alissa Herzog | Internal Medicine | 229 Montowese St, Branford, CT 06405-3828 | 2009-05-01 |
| 1356480578 | Digestive Disease Associates, LLC | Internal Medicine | 229 Montowese St, Branford, CT 06405-3828 | 2007-02-05 |
| 1609836998 | Christopher Dunbar Illick | Internal Medicine | 229 Montowese St, Branford, CT 06405-3828 | 2006-03-23 |
| 1477513760 | Jack Chuong | Internal Medicine | 229 Montowese St, Branford, CT 06405-2821 | 2006-03-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770119596 | Katarzyna Pavelko | Physical Therapist | Branford Hills, 189 Alps Rd, Branford, CT 06405 | 2020-03-13 |
| 1174027213 | C & M Health Services Branford LLC | Home Health | 625 East Main Street, Branford, CT 06405 | 2018-03-22 |
| 1689181554 | Erin H Mccarthy | Social Worker | 513 Leetes Island Rd, Branford, CT 06405 | 2018-01-02 |
| 1255860516 | Sylcom Angelscare LLC | In Home Supportive Care | 1204 Main Street #241, Branford, CT 06405 | 2017-06-08 |
| 1093266439 | Emmanuel Chery | Physical Therapy Assistant | 153 Austin Ryer Lane, Branford, CT 06405 | 2016-10-20 |
| 1114389681 | Suraj Patel | Pharmacist | 2-6 Short Beach Rd, Branford, CT 06405 | 2016-03-24 |
| 1558753897 | Donald Ray Sirry | Social Worker | 9 Business Park Drive, Unit 1, Branford, CT 06405 | 2015-02-24 |
| 1952679110 | Maria Rivera Heath Lmft, LLC | Marriage & Family Therapist | 388 East Main Street, Suite 19, Branford, CT 06405 | 2011-12-02 |
| 1942587035 | Kathryn Lyn Delia | Pharmacist | 329 East Main St, Branford, CT 06405 | 2011-11-03 |
| 1447554068 | Elizabeth's Home Health Care Agency L.L.C. | Home Health | 127 Cedar Street, Bronford, CT 06405 | 2010-12-23 |
| Find all providers in zip 06405 | ||||
| Taxonomy Code | 261QA1903X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Ambulatory Surgical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1477017648 | Connecticut Orthopaedic Surgery Center, LLC | Clinic/Center | 205 Sub Way Drive, Milford, CT 06461 | 2019-01-22 |
| 1083188478 | Rocky Hill Surgery Center, LLC | Clinic/Center | 1111 Cromwell Ave Ste 100, Rocky Hill, CT 06067-3449 | 2019-01-18 |
| 1922576818 | Greater New Haven Asc, LLC | Clinic/Center | 2080 Whitney Ave Ste 100, Hamden, CT 06518-3603 | 2018-11-08 |
| 1396120168 | Stamford Asc LLC | Clinic/Center | 200 First Stamford Pl, Stamford, CT 06902-6753 | 2015-07-22 |
| 1821332370 | River Valley Asc LLC | Clinic/Center | 45 Salem Tpke, Norwich, CT 06360-6533 | 2012-11-22 |
| 1164732426 | Norwalk Surgery Center, LLC | Clinic/Center | 40 Cross St Ste 120, Norwalk, CT 06851-4698 | 2010-10-20 |
| 1326356320 | Orthopaedic & Neurosurgery Center of Greenwich, LLC | Clinic/Center | 55 Holly Hill Lane, Greenwich, CT 06830 | 2010-09-24 |
| 1053628883 | Plastic Surgery of So Ct | Clinic/Center | 208 Post Rd W, Westport, CT 06880-4604 | 2010-08-31 |
| 1932438553 | Middlesex Center for Advanced Orthopedic Surgery, LLC | Clinic/Center | 510 Saybrook Road, Middletown, CT 06457-4711 | 2009-12-10 |
| 1497904296 | International Cosmetic Surgery | Clinic/Center | 2 Mercia Ln, Greenwich, CT 06830-7068 | 2008-09-17 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DIGESTIVE DISEASE ASSOCIATES ENDOSCOPY SUITE, LLC.
| 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.