Active NPI
Federal Hill Otolaryngology, PC
- Otolaryngology Physician
- Bristol, CT
National Provider Identifier
1043255789
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Otolaryngology Physician
- License
- 033390
- Legal business name
- FEDERAL HILL OTOLARYNGOLOGY, PC
- Practice address
- 291 Queen St
Bristol, CT 06010-6379 - Phone
- (860) 583-1845
- NPI assigned
- Jun 17, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Valerie J Vitale, MD
- Title
- President
- Phone
- (860) 583-1845
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Otolaryngology Physician | 207Y00000X | 033390 | CT | Primary |
Addresses
Primary practice location
291 Queen St
Bristol, CT 06010-6379
Mailing address
291 Queen St
Bristol, CT 06010-6379
Phone (860) 583-1845
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 010033390CT | Other | CT | ANTHEM |
| HAS 077 | Other | CT | OXFORD |
| 0271873004 | Other | CT | CIGNA |
| 033390 | Other | CT | CONNECTICARE |
National Provider Directory
National Provider DirectoryLocations
291 Queen St
Bristol, CT 06010
Phone (860) 583-1845
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
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- New York, NY
- NPI 1710947379
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150502400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1043255789",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "291 QUEEN ST",
"city": "BRISTOL",
"state": "CT",
"postal_code": "060106379",
"telephone_number": "860-583-1845"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "291 QUEEN ST",
"city": "BRISTOL",
"state": "CT",
"postal_code": "060106379",
"telephone_number": "860-583-1845"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FEDERAL HILL OTOLARYNGOLOGY, PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-17",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "VITALE",
"authorized_official_first_name": "VALERIE",
"authorized_official_middle_name": "J",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "860-583-1845",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "207Y00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Otolaryngology",
"state": "CT",
"license": "033390",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM",
"identifier": "010033390CT",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "HAS 077",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "0271873004",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CONNECTICARE",
"identifier": "033390",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bristol, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.