NPIMap

Organization Active NPI

Medical Oncology and Blood Disorders, LLP

  • Hematology & Oncology Physician
  • Manchester, CT
National Provider Identifier
1225045636
Registry record updated Jun 18, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
Legal business name
MEDICAL ONCOLOGY AND BLOOD DISORDERS, LLP
Practice address
100 Haynes St FL 2
Dequattro Community Cancer Center
Manchester, CT 06040-4113
Phone
(860) 646-0670
Fax
(860) 643-9388
NPI assigned
Aug 1, 2006
Last updated
Jun 18, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 18, 2013

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

Authorized official

Name
Mrs. Doris Byrem, RN
Title
Administrator
Phone
(860) 533-3091

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hematology & Oncology Physician 207RH0003X NU Primary

Addresses

Primary practice location

100 Haynes St FL 2
Dequattro Community Cancer Center
Manchester, CT 06040-4113

Mailing address

100 Haynes St FL 2
Business Office
Manchester, CT 06040-4113
Phone (860) 533-3091

Other identifiers 1

IdentifierTypeStateIssuer
004395085MedicaidCT

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371513600000",
    "number": "1225045636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HAYNES ST FL 2",
            "address_2": "BUSINESS OFFICE",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404113",
            "telephone_number": "860-533-3091",
            "fax_number": "860-533-3096"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HAYNES ST FL 2",
            "address_2": "DEQUATTRO COMMUNITY CANCER CENTER",
            "city": "MANCHESTER",
            "state": "CT",
            "postal_code": "060404113",
            "telephone_number": "860-646-0670",
            "fax_number": "860-643-9388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ONCOLOGY AND BLOOD DISORDERS, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2013-06-18",
        "status": "A",
        "authorized_official_last_name": "BYREM",
        "authorized_official_first_name": "DORIS",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "860-533-3091",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004395085",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2013; 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.