NPIMap

Organization Active NPI

East Shore District Health Department

  • Public Health or Welfare Agency
  • Branford, CT
National Provider Identifier
1437490349
Registry record updated Mar 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Public Health or Welfare AgencyTaxonomy code 251K00000X
License
028111 Issued in CT
Legal business name
EAST SHORE DISTRICT HEALTH DEPARTMENT
Practice address
688 E Main St
Branford, CT 06405-2971
Phone
(203) 481-4233
Fax
(203) 483-6894
NPI assigned
Mar 4, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2023

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

Authorized official

Name
Dr. Richard Young, MD
Title
Medical Director
Phone
(203) 675-4055

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X 028111 CT Primary

Addresses

Primary practice location

688 E Main St
Branford, CT 06405-2971

Mailing address

688 E Main St
Branford, CT 06405-2971
Phone (203) 481-4233

Other names 1

  • ESDHD Travel Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
East Shore Dist Health Dept2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1362355200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1679356800000",
    "number": "1437490349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "688 E MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064052971",
            "telephone_number": "203-481-4233",
            "fax_number": "203-483-6894"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "688 E MAIN ST",
            "city": "BRANFORD",
            "state": "CT",
            "postal_code": "064052971",
            "telephone_number": "203-481-4233",
            "fax_number": "203-483-6894"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAST SHORE DISTRICT HEALTH DEPARTMENT",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-03-04",
        "last_updated": "2023-03-21",
        "certification_date": "2023-03-21",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "203-675-4055",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "CT",
            "license": "028111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "ESDHD Travel Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ESDHD Travel Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Branford, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2023; 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.