Active NPI
Haleh Ghanizadeh, M.D., M.P.H.
- Forensic Psychiatry Physician
- Ridgefield, CT
National Provider Identifier
1619113446
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Forensic Psychiatry Physician
- License
- 041249
- Practice address
- 83 West LN
Ridgefield, CT 06877-4905 - Phone
- (203) 438-2441
- Fax
- (203) 438-1011
- NPI assigned
- Dec 29, 2008
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Forensic Psychiatry Physician | 2084F0202X | 041249 | CT | Primary |
| Psychiatry Physician | 2084P0800X | 041249 | CT |
Addresses
Primary practice location
83 West LN
Ridgefield, CT 06877-4905
Mailing address
PO Box 537
Ridgefield, CT 06877-0537
Phone (203) 438-2441
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Sep 15, 2021 through Sep 15, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 041249 | CT | MD | Psychiatry Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1230508800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1230508800000",
"number": "1619113446",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 537",
"city": "RIDGEFIELD",
"state": "CT",
"postal_code": "068770537",
"telephone_number": "203-438-2441",
"fax_number": "203-438-1011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "83 WEST LN",
"city": "RIDGEFIELD",
"state": "CT",
"postal_code": "068774905",
"telephone_number": "203-438-2441",
"fax_number": "203-438-1011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GHANIZADEH",
"first_name": "HALEH",
"credential": "M.D., M.P.H.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-12-29",
"last_updated": "2008-12-29",
"status": "A"
},
"taxonomies": [
{
"code": "2084F0202X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Forensic Psychiatry",
"state": "CT",
"license": "041249",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "CT",
"license": "041249",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ridgefield, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.