Active NPI
Meriden-Wallingford Anesthesia Group PC
- Anesthesiology Physician
- Meriden, CT
National Provider Identifier
1073558508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- Legal business name
- MERIDEN-WALLINGFORD ANESTHESIA GROUP PC
- Practice address
- 435 Lewis Ave
Meriden, CT 06451-2101 - Phone
- (203) 694-8200
- NPI assigned
- Jun 18, 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
- Kathleen Kondas
- Title
- Officer
- Phone
- (954) 838-2371
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | Primary |
Addresses
Primary practice location
435 Lewis Ave
Meriden, CT 06451-2101
Mailing address
PO Box 744473
Atlanta, GA 30374-4473
Phone (107) 355-8508
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004000733 | Medicaid | CT |
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150588800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1568678400000",
"number": "1073558508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 744473",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303744473",
"telephone_number": "107-355-8508",
"fax_number": "913-242-6850"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "435 LEWIS AVE",
"city": "MERIDEN",
"state": "CT",
"postal_code": "064512101",
"telephone_number": "203-694-8200"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MERIDEN-WALLINGFORD ANESTHESIA GROUP PC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-18",
"last_updated": "2019-09-17",
"status": "A",
"authorized_official_last_name": "KONDAS",
"authorized_official_first_name": "KATHLEEN",
"authorized_official_title_or_position": "OFFICER",
"authorized_official_telephone_number": "954-838-2371"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Anesthesiology",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004000733",
"state": "CT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Meriden, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.