Organization Active NPI

Mobile CV Imaging, LLC

  • Cardiovascular Disease Physician
  • Bridgeport, CT
National Provider Identifier
1033367743
Registry record updated Sep 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
033357 Issued in CT
Legal business name
MOBILE CV IMAGING, LLC
Practice address
136 Grovers Ave
Bridgeport, CT 06605-3536
Phone
(203) 767-3332
Fax
(203) 612-8391
NPI assigned
Sep 5, 2008
Last updated
Sep 5, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2008

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

Authorized official

Name
Ms. Sybil Gauthier Malkin
Title
Manager
Phone
(203) 331-7597

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207RC0000X 033357 CT Primary

Addresses

Primary practice location

136 Grovers Ave
Bridgeport, CT 06605-3536

Mailing address

136 Grovers Ave
Bridgeport, CT 06605-3536
Phone (203) 767-3332

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1220572800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1220572800000",
    "number": "1033367743",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 GROVERS AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066053536",
            "telephone_number": "203-767-3332",
            "fax_number": "203-612-8391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "136 GROVERS AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066053536",
            "telephone_number": "203-767-3332",
            "fax_number": "203-612-8391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILE CV IMAGING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-05",
        "last_updated": "2008-09-05",
        "status": "A",
        "authorized_official_last_name": "MALKIN",
        "authorized_official_first_name": "SYBIL",
        "authorized_official_middle_name": "GAUTHIER",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "203-331-7597",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "CT",
            "license": "033357",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgeport, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2008; 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.