Terrence A Doherty (NPI# 1255435558, PAC ID# 0345425781) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1255435558 |
| PAC ID by PECOS | 0345425781 |
| Professional Enrollment ID | I20110428000020 |
| Full Name | Terrence A Doherty |
| Organization Legal Name | NORTHEAST MEDICAL GROUP INC |
| Address |
19 Halls Rd Old Lyme CT 06371-1457 |
| Phone Number | 8604348300 |
| Gender | M |
| Medical School | TEMPLE UNIVERSITY SCHOOL OF MEDICINE |
| Graduation Year | 1986 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 1254233836 |
| Number of Group Practice Members | 1014 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 070007 | LAWRENCE & MEMORIAL HOSPITAL |
| 070022 | YALE-NEW HAVEN HOSPITAL |
| 070020 | MIDDLESEX HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 19 Halls Rd, Old Lyme, CT 06371-1457 | 8604348300 | NORTHEAST MEDICAL GROUP INC |
| 95 Armory Rd, Stratford, CT 06614-1702 | 2033843388 | NORTHEAST MEDICAL GROUP INC |
| Organization Legal Name | NORTHEAST MEDICAL GROUP INC |
| Physicians | 1113 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Daniel J Razzano | Internal Medicine | Northeast Medical Group Inc | 1 Long Wharf Dr, New Haven, CT 06511-5991 |
| Irene Besser | Certified Nurse Midwife (cnm) | Northeast Medical Group Inc | 3 Shaws Cv, New London, CT 06320-4952 |
| Ang Zhang | Internal Medicine | Northeast Medical Group Inc | 50 Gaylord Farm Rd, Wallingford, CT 06492-2828 |
| Carolyn Brown | Nurse Practitioner | Northeast Medical Group Inc | 112 Quarry Rd, Suite 400, Trumbull, CT 06611-4877 |
| Nicole Parry | Nurse Practitioner | Northeast Medical Group Inc | 999 Silver Lane, Trumbull, CT 06611-5343 |
| Amanda L Hall | Nurse Practitioner | Northeast Medical Group Inc | 1308 Chapel St, New Haven, CT 06511-4515 |
| Murielle Exantus | Nurse Practitioner | Northeast Medical Group Inc | 422 Highland Ave, Cheshire, CT 06410-2526 |
| Brittany L Provenzano | Nurse Practitioner | Northeast Medical Group Inc | 887 Bridgeport Ave, Shelton, CT 06484-7602 |
| Pradnya Velankar | Cardiovascular Disease (cardiology) | Northeast Medical Group Inc | 230 Waterford Pkwy S, Waterford, CT 06385-1219 |
| Kitima Boonvisudhi | General Surgery | Northeast Medical Group Inc | 40 Boston Post Rd, Waterford, CT 06385-2424 |
| Street Address |
19 HALLS RD |
| City | OLD LYME |
| State | CT |
| Zip | 06371-1457 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Jay Graves | Family Medicine | Northeast Medical Group Inc | 19 Halls Rd, Old Lyme, CT 06371-1457 |
| Olaf J Ogland | Psychiatry | 19 Halls Rd, Suite 235, Old Lyme, CT 06371-1457 | |
| Suresh Dmello | Family Medicine | Northeast Medical Group Inc | 19 Halls Rd, Old Lyme, CT 06371-1457 |
| Steven J Difilippo | Clinical Social Worker | 19 Halls Rd, Suite 234, Old Lyme, CT 06371-1457 | |
| Christine A Semenza | Optometry | 19 Halls Rd, Suite 210, Old Lyme, CT 06371-1457 | |
| Ellen B Schnier | Clinical Social Worker | 19 Halls Rd, Suite 234, Old Lyme, CT 06371-1457 | |
| Lauren Eddy | Nurse Practitioner | Northeast Medical Group Inc | 19 Halls Rd, Old Lyme, CT 06371-1457 |
| Susan Ferrier Lang | Physical Therapy | 19 Halls Rd, Suite 213, Old Lyme, CT 06371-1457 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| David F Zita | Psychologist, Clinical | 164 Four Mile River Rd, Old Lyme, CT 06371-1325 | |
| Ann Therese Haydu | Clinical Social Worker | 12 Jericho Dr, Old Lyme, CT 06371-1326 | |
| Vinod V Pathy | Plastic and Reconstructive Surgery | 5 Davis Rd E, Old Lyme, CT 06371-1413 | |
| David J Frederiks | Family Medicine | 8 Davis Rd W, Old Lyme, CT 06371-1448 | |
| Bennett Edward Moehl | Psychologist, Clinical | Medop Behavioral Health Associates PC | 55 Hatchetts Hill Rd, Old Lyme, CT 06371-1534 |
| Cora D Zembrzuski | Certified Clinical Nurse Specialist (cns) | Medop Behavioral Health Associates PC | 55 Hatchetts Hill Rd, Old Lyme, CT 06371-1534 |
| Donna M Wallace | Nurse Practitioner | Medop Behavioral Health Associates PC | 55 Hatchetts Hill Rd, Old Lyme, CT 06371-1534 |
| Karen Donovan | Nurse Practitioner | Medop Behavioral Health Associates PC | 55 Hatchetts Hill Rd, Old Lyme, CT 06371-1534 |
| Debora Doyle Ouellette | Nurse Practitioner | Medop Behavioral Health Associates PC | 55 Hatchetts Hill Rd, Old Lyme, CT 06371-1534 |
| Alyson M Nicolosi | Nurse Practitioner | Medop Behavioral Health Associates PC | 55 Hatchetts Hill Rd, Old Lyme, CT 06371-1534 |
| Find all physicians in zip 06371 | |||
| City | OLD LYME |
| Zip Code | 06371 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | OLD LYME + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Terrence A Doherty.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.