Waterbury Neurology LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

Legal business name

WATERBURY NEUROLOGY LLC

Practice address

1625 Straits Turnpike
Suite 307
Middlebury, CT 06762-1836

Phone

(203) 758-8995

Fax

(203) 758-2571

NPI assigned

Jun 2, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Pooia Fattahi, MD

Title

Partner

Phone

(203) 758-8995

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

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

• Kenneth G Kaplove, M.D.

  • Neurology Physician
  • Middlebury, CT
  • NPI 1316979990
  NPD (past)

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461888000000",
    "number": "1255378501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 STRAITS TURNPIKE",
            "address_2": "SUITE 307",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621836",
            "telephone_number": "203-758-8995",
            "fax_number": "203-758-2571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 STRAITS TURNPIKE",
            "address_2": "SUITE 307",
            "city": "MIDDLEBURY",
            "state": "CT",
            "postal_code": "067621836",
            "telephone_number": "203-758-8995",
            "fax_number": "203-758-2571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WATERBURY NEUROLOGY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-02",
        "last_updated": "2016-04-29",
        "status": "A",
        "authorized_official_last_name": "FATTAHI",
        "authorized_official_first_name": "POOIA",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "203-758-8995",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1284603",
            "state": "CT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1361138",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Vincent A. Viega Jr., LCSW
• Vincent a. Viega, Jr.
• Vista Dental Associates (Middlebury Dental Center)
• Vitas Healthcare Corporation Atlantic
• Bohdan J Warycha, MD
• Jannese Lauren Webber, LCSW, LADC
• Xiao Jun Weng, MD
• Robert William White, CO
• Wilfred Brown, MD PC
• Kimberly Wilson

• Neurology Physician in Middlebury, CT
• Providers in Middlebury, CT by specialty
• Neurology Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2016; 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.