Individual provider Active NPI

Issahar Ben-Dov

  • Pulmonary Disease Physician
  • New Haven, CT
National Provider Identifier
1356761290
Registry record updated Apr 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pulmonary Disease PhysicianTaxonomy code 207RP1001X
License
52904 Issued in CT
Practice address
300 Cedar St, Pulmonary &Critical Care Section
Tac-441 South
New Haven, CT 06520-8057
Phone
(203) 785-4162
Fax
(203) 785-3826
NPI assigned
Apr 18, 2014
Last updated
Apr 18, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pulmonary Disease Physician 207RP1001X 52904 CT Primary

Addresses

Primary practice location

300 Cedar St, Pulmonary &Critical Care Section
Tac-441 South
New Haven, CT 06520-8057

Mailing address

Pob 208057, Tac-441 South
300 Cedar St, Pulmonary &Critical Care Section
New Haven, CT 06520-8057
Phone (203) 785-4162

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

LicenseStateTypeSpecialty
52904CTMDPulmonary Disease Physician

NPI Registry JSON

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

{
    "created_epoch": "1397779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397779200000",
    "number": "1356761290",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "POB 208057, TAC-441 SOUTH",
            "address_2": "300 CEDAR ST, PULMONARY &CRITICAL CARE SECTION",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208057",
            "telephone_number": "203-785-4162",
            "fax_number": "203-785-3826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CEDAR ST, PULMONARY &CRITICAL CARE SECTION",
            "address_2": "TAC-441 SOUTH",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208057",
            "telephone_number": "203-785-4162",
            "fax_number": "203-785-3826"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEN-DOV",
        "first_name": "ISSAHAR",
        "name_prefix": "Prof.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-18",
        "last_updated": "2014-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CT",
            "license": "52904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2014; 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.