Active NPI
New London Cancer Center, P.C.
- Hematology & Oncology Physician
- Waterford, CT
National Provider Identifier
1376596825
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hematology & Oncology Physician
- Legal business name
- NEW LONDON CANCER CENTER, P.C.
- Practice address
- 196 Parkway S
Suite 303
Waterford, CT 06385-1234 - Phone
- (860) 443-4455
- Fax
- (860) 447-8961
- NPI assigned
- May 18, 2006
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Mithlesh Govil, M.D.
- Title
- Physician/Owner
- Phone
- (860) 443-4455
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Hematology & Oncology Physician | 207RH0003X | CT | Primary |
Addresses
Primary practice location
196 Parkway S
Suite 303
Waterford, CT 06385-1234
Mailing address
196 Parkway S
Suite 304
Waterford, CT 06385-1234
Phone (860) 442-7027
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004222600 | Medicaid | CT | |
| 008022601 | Other | CT | MEDICAID APRN GROUP |
Other names 1
- New London Cancer Center, Inc.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147910400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1380067200000",
"number": "1376596825",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "196 PARKWAY S",
"address_2": "SUITE 304",
"city": "WATERFORD",
"state": "CT",
"postal_code": "063851234",
"telephone_number": "860-442-7027",
"fax_number": "866-861-9119"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "196 PARKWAY S",
"address_2": "SUITE 303",
"city": "WATERFORD",
"state": "CT",
"postal_code": "063851234",
"telephone_number": "860-443-4455",
"fax_number": "860-447-8961"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "NEW LONDON CANCER CENTER, P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-18",
"last_updated": "2013-09-25",
"status": "A",
"authorized_official_last_name": "GOVIL",
"authorized_official_first_name": "MITHLESH",
"authorized_official_title_or_position": "PHYSICIAN/OWNER",
"authorized_official_telephone_number": "860-443-4455",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "M.D."
},
"taxonomies": [
{
"code": "207RH0003X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Internal Medicine, Hematology & Oncology",
"state": "CT",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "004222600",
"state": "CT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAID APRN GROUP",
"identifier": "008022601",
"state": "CT"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "New London Cancer Center, Inc.",
"code": "4",
"type": "Former Legal Business Name"
}
]
}
Other providers in Waterford, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.