Coastal Digestive Diseases PC

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

3032224000 Issued in CT

Legal business name

COASTAL DIGESTIVE DISEASES PC

Practice address

234 Bank St
4TH Floor
New London, CT 06320-6070

Phone

(860) 442-0290

Fax

(860) 442-2136

NPI assigned

Mar 7, 2007

Last updated

Dec 7, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. George S Ouellette, M.D.

Title

President

Phone

(860) 442-0290

Specialties & licenses 2

Addresses

Locations

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.

• Ramon Generoso, MD

  • Gastroenterology Physician
  • Kalispell, MT
  • NPI 1326029281
  NPD (past)

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1323216000000",
    "number": "1053441147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "234A BANK ST",
            "address_2": "4TH FLOOR",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206054",
            "telephone_number": "860-442-0290",
            "fax_number": "860-442-2136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "234 BANK ST",
            "address_2": "4TH FLOOR",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063206070",
            "telephone_number": "860-442-0290",
            "fax_number": "860-442-2136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL DIGESTIVE DISEASES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-07",
        "last_updated": "2011-12-07",
        "status": "A",
        "authorized_official_last_name": "OUELLETTE",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "860-442-0290",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "CT",
            "license": "3032224000",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "CT",
            "license": "3032224000",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sean Clark, HS1
• Holden E Clauson, D.D.S.
• Coastal Connecticut Research LLC (CCRstudies.com)
• Coastal Digestive Care Center LLC
• Coastal Digestive Diseases
• Margo R. Coffey, PA-C
• Stephen Richard Cofone
• Grace Cogan
• Suzanne Cohen-Ireylikhman, MFT
• Jennifer Tara Cohen, BA

• Adult Medicine Physician in New London, CT
• Providers in New London, CT by specialty
• Adult Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 2011; 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.