Southern Connecticut Geriatric & Preventive Medicine LLC

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

041288 Issued in CT

Legal business name

SOUTHERN CONNECTICUT GERIATRIC & PREVENTIVE MEDICINE LLC

Practice address

390 Livingston St
New Haven, CT 06511-1336

Phone

(203) 871-9224

NPI assigned

Jun 25, 2009

Organization subpart

No

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

Authorized official

Name

Dr. Asefeh Heiat, M.D., M.P.H.NPI 1033119813

Title

Member

Phone

(203) 871-9224

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Practitioners 1

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

• Asefeh Heiat, M.D., M.P.H.

  • Geriatric Medicine (Internal Medicine) Physician
  • New Haven, CT
  • NPI 1033119813

  Multi-Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1245888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1633305600000",
    "number": "1679701882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 LIVINGSTON ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065111336",
            "telephone_number": "203-871-9224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 LIVINGSTON ST",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065111336",
            "telephone_number": "203-871-9224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CONNECTICUT GERIATRIC & PREVENTIVE MEDICINE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-25",
        "last_updated": "2021-10-04",
        "certification_date": "2021-10-04",
        "status": "A",
        "authorized_official_last_name": "HEIAT",
        "authorized_official_first_name": "ASEFEH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "203-871-9224",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D., M.P.H."
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "CT",
            "license": "041288",
            "primary": true
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2083P0901X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Preventive Medicine, Public Health & General Preventive Medicine",
            "state": "CT",
            "license": "041288",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cristina Vanessa Soto, MD
• Elaine Soto, MSW
• Alexander Daniel Sotolongo, MD
• Claudia Soulds, LPN
• Rachel Christina Southard
• Southern Connecticut Internal Medicine
• Southern Connecticut Internal Medicine
• Southern Home Care Services, Inc.
• Southern New England Ear, Nose, Throat & Facial Plastic Surg GRP. LCP
• Southern New England Ear, Nose, Throat and Facial Plastic Surgery Grou

• Geriatric Medicine (Internal Medicine) Physician in New Haven, CT
• Providers in New Haven, CT by specialty
• Geriatric Medicine (Internal Medicine) Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.