NPIMap

Organization Active NPI

Shoreline Psychiatric

  • Psychiatry Physician
  • Branford, CT
National Provider Identifier
1023497302
Registry record updated May 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
034237 Issued in CT
Legal business name
SHORELINE PSYCHIATRIC
Practice address
226 E Main St
Branford, CT 06405-3103
Phone
(203) 871-1357
Fax
(203) 488-5034
NPI assigned
May 20, 2015
Last updated
May 20, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 20, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kathleen Marie Lazzarini, M.D.
Title
President
Phone
(203) 871-1357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 034237 CT Primary

Addresses

Primary practice location

226 E Main St
Branford, CT 06405-3103

Mailing address

226 E Main St
Branford, CT 06405-3103
Phone (203) 871-1357

Other identifiers 1

IdentifierTypeStateIssuer
001342378MedicaidCT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432080000000",
    "number": "1023497302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "226 E MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053103",
            "telephone_number": "203-871-1357",
            "fax_number": "203-488-5034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "226 E MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064053103",
            "telephone_number": "203-871-1357",
            "fax_number": "203-488-5034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SHORELINE PSYCHIATRIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-20",
        "last_updated": "2015-05-20",
        "status": "A",
        "authorized_official_last_name": "LAZZARINI",
        "authorized_official_first_name": "KATHLEEN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "203-871-1357",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "CT",
            "license": "034237",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001342378",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Branford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.