Active NPI
Daniela Lares, MD
- Psychiatry Physician
- Meriden, CT
National Provider Identifier
1205096401
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 046472
- Practice address
- 134 State St
Meriden, CT 06450-3293 - Phone
- (203) 237-2229
- Fax
- (203) 686-1677
- NPI assigned
- Jun 11, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 046472 | CT | Primary |
Addresses
Primary practice location
134 State St
Meriden, CT 06450-3293
Mailing address
635 Main St
Attn: Credentialing DPT
Middletown, CT 06457-2718
Phone (860) 347-6971
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004236338 | Medicaid | CT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 046472 | CT | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greater Hartford Psychiatric Services, LLC | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Child & Adolescent Psychiatry Physician
- Hartford, CT
- NPI 1275974321
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213142400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1213142400000",
"number": "1205096401",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "635 MAIN ST",
"address_2": "ATTN: CREDENTIALING DPT",
"city": "MIDDLETOWN",
"state": "CT",
"postal_code": "064572718",
"telephone_number": "860-347-6971",
"fax_number": "860-638-6601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "134 STATE ST",
"city": "MERIDEN",
"state": "CT",
"postal_code": "064503293",
"telephone_number": "203-237-2229",
"fax_number": "203-686-1677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LARES",
"first_name": "DANIELA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-11",
"last_updated": "2008-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "046472",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004236338",
"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 Jun 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.