East Shore District Health Department

Primary specialty

Public Health or Welfare AgencyTaxonomy code 251K00000X

License

028111 Issued in CT

Legal business name

EAST SHORE DISTRICT HEALTH DEPARTMENT

Practice address

688 E Main St
Branford, CT 06405-2971

Phone

(203) 481-4233

Fax

(203) 483-6894

NPI assigned

May 25, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Richard Young, MD

Title

Medical Advisor

Phone

(203) 481-4233

Specialties & licenses 1

Addresses

Other names 1

• East Shore Health District Other name

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Tax ID family

East Shore Dist Health Dept2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• East Shore District Health Department

  dba ESDHD Travel Clinic

  • Public Health or Welfare Agency
  • Branford, CT
  • NPI 1437490349
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Margaret Kiyo Ikeda, M.D.

  • Pediatrics Physician
  • New Haven, CT
  • NPI 1750475117
  NPD

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658188800000",
    "number": "1184670176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "688 E MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064052971",
            "telephone_number": "203-481-4233",
            "fax_number": "203-483-6894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688 E MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064052971",
            "telephone_number": "203-481-4233",
            "fax_number": "203-483-6894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SHORE DISTRICT HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-25",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "MEDICAL ADVISOR",
        "authorized_official_telephone_number": "203-481-4233",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "CT",
            "license": "028111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "East Shore Health District",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "East Shore Health District",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Suzanne Mary Duran Crelin, LCSW
• Mahoghany Durso
• Dva Renal Healthcare Inc (Branford Dialysis)
• Dziura Chiropractic PC
• David B. Dziura, DC
• East Shore District Health Department (ESDHD Travel Clinic)
• East Shore Regional Adult Day Care Center, Inc (The Orchard House Medical Adult Day Center)
• East West Integrative Health Clinic, LLC (EWI Health)
• Ebb & Flow Creative Psychotherapy, LLC
• Edward S Lim, MD, LLC

• Public Health or Welfare Agency in Branford, CT
• Providers in Branford, CT by specialty
• Public Health or Welfare Agency in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.