NPIMap

Organization Active NPI

CT Comprehensive Medical PLLC

  • Obesity Medicine (Family Medicine) Physician
  • Oxford, CT
National Provider Identifier
1104528587
Registry record updated Mar 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Family Medicine) PhysicianTaxonomy code 207QB0002X
Legal business name
CT COMPREHENSIVE MEDICAL PLLC
Practice address
71 Oxford Rd Unit L
Oxford, CT 06478-1900
Phone
(203) 828-0013
NPI assigned
Mar 20, 2023
Organization subpart
Yes
Parent organization
CT COMPREHENSIVE MEDICAL PLLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 20, 2023

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

Authorized official

Name
Deidre Schettino
Title
Manager
Phone
(845) 464-6289

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QB0002X Primary

Addresses

Primary practice location

71 Oxford Rd Unit L
Oxford, CT 06478-1900

Mailing address

71 Oxford Rd Unit L
Oxford, CT 06478-1900
Phone (203) 828-0013

National Provider Directory

National Provider Directory
Tax ID family
CT Comprehensive Medical PLLC3 organizations share this tax ID, including this one
Part of
CT Comprehensive Medical PLLC

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1679270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679270400000",
    "number": "1104528587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "71 OXFORD RD UNIT L",
            "city": "OXFORD",
            "state": "CT",
            "postal_code": "064781900",
            "telephone_number": "203-828-0013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "71 OXFORD RD UNIT L",
            "city": "OXFORD",
            "state": "CT",
            "postal_code": "064781900",
            "telephone_number": "203-828-0013"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CT COMPREHENSIVE MEDICAL PLLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "CT COMPREHENSIVE MEDICAL PLLC",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-03-20",
        "certification_date": "2023-03-20",
        "status": "A",
        "authorized_official_last_name": "SCHETTINO",
        "authorized_official_first_name": "DEIDRE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "845-464-6289"
    },
    "taxonomies": [
        {
            "code": "207QB0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Obesity Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oxford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2023; 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.