Active NPI
William Ghavami Frederick, MD
- Anatomic Pathology & Clinical Pathology Physician
- Waterbury, CT
National Provider Identifier
1548270572
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anatomic Pathology & Clinical Pathology Physician
- License
- 029837
- Practice address
- 56 Franklin St
Waterbury, CT 06706 - Phone
- (203) 709-6053
- Fax
- (203) 709-3156
- NPI assigned
- Aug 9, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anatomic Pathology & Clinical Pathology Physician | 207ZP0102X | 029837 | CT | Primary |
Addresses
Primary practice location
56 Franklin St
Waterbury, CT 06706
Mailing address
PO Box 6305
Church Street Station
New York, NY 10249-6305
Phone (800) 214-2888
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155081600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1548270572",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 6305",
"address_2": "CHURCH STREET STATION",
"city": "NEW YORK",
"state": "NY",
"postal_code": "102496305",
"telephone_number": "800-214-2888",
"fax_number": "207-753-2100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "56 FRANKLIN ST",
"city": "WATERBURY",
"state": "CT",
"postal_code": "06706",
"telephone_number": "203-709-6053",
"fax_number": "203-709-3156"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICK",
"first_name": "WILLIAM",
"middle_name": "GHAVAMI",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-09",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207ZP0102X",
"taxonomy_group": "",
"desc": "Pathology, Anatomic Pathology & Clinical Pathology",
"state": "CT",
"license": "029837",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waterbury, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.