Amit Mahajan LLC

Primary specialty

Medical Specialty Clinic/CenterTaxonomy code 261QM2500X

License

040955 Issued in CT

Legal business name

AMIT MAHAJAN LLC

Practice address

28 Split Rock Rd
Trumbull, CT 06611-2650

Phone

(203) 685-6976

Fax

(203) 445-1699

NPI assigned

May 4, 2008

Last updated

May 4, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Amit Mahajan, M.D.NPI 1710018304

Title

Director

Phone

(203) 685-6976

Specialties & licenses 2

Addresses

Practitioners 1

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.

• Amit Mahajan, MD

  • Internal Medicine Physician
  • Trumbull, CT
  • NPI 1710018304
  NPD (past) Authorized official

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

{
    "created_epoch": "1209859200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209859200000",
    "number": "1356517908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 SPLIT ROCK RD",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066112650",
            "telephone_number": "203-685-6976",
            "fax_number": "203-445-1699"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28 SPLIT ROCK RD",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066112650",
            "telephone_number": "203-685-6976",
            "fax_number": "203-445-1699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMIT MAHAJAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-04",
        "last_updated": "2008-05-04",
        "status": "A",
        "authorized_official_last_name": "MAHAJAN",
        "authorized_official_first_name": "AMIT",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "203-685-6976",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": "CT",
            "license": "040955",
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "CT",
            "license": "040955",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Medical Specialty Clinic/Center in Trumbull, CT
• Providers in Trumbull, CT by specialty
• Medical Specialty Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 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.

Verify at the official NPI Registry.