NPIMap

Organization Active NPI

Ellen G. Polokoff MD, LLC

  • Surgery Physician
  • Southbury, CT
National Provider Identifier
1407054950
Registry record updated Oct 29, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
035653 Issued in CT
Legal business name
ELLEN G. POLOKOFF MD, LLC
Practice address
900 Main St S
Southbury, CT 06488-4237
Phone
(203) 262-2300
NPI assigned
Jul 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 29, 2007

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

Authorized official

Name
Ellen PolokoffNPI 1487671178
Title
Physician Owner
Phone
(203) 262-2300

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208600000X 035653 CT Primary

Addresses

Primary practice location

900 Main St S
Southbury, CT 06488-4237

Mailing address

900 Main St S
Southbury, CT 06488-4237
Phone (203) 262-2300

National Provider Directory

National Provider Directory

Locations

900 Main St S
Southbury, CT 06488
Phone (203) 262-1911

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1183680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1193616000000",
    "number": "1407054950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 MAIN ST S",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064884237",
            "telephone_number": "203-262-2300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 MAIN ST S",
            "city": "SOUTHBURY",
            "state": "CT",
            "postal_code": "064884237",
            "telephone_number": "203-262-2300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELLEN G. POLOKOFF MD, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-06",
        "last_updated": "2007-10-29",
        "status": "A",
        "authorized_official_last_name": "POLOKOFF",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "PHYSICIAN OWNER",
        "authorized_official_telephone_number": "203-262-2300"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "CT",
            "license": "035653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southbury, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; 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.