Organization Active NPI

Internal Medicine Associates of Norwich LLC

  • Nephrology Physician
  • Norwich, CT
National Provider Identifier
1679776876
Registry record updated Jul 20, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nephrology PhysicianTaxonomy code 207RN0300X
License
034177 Issued in CT
Legal business name
INTERNAL MEDICINE ASSOCIATES OF NORWICH LLC
Practice address
119 Sachem St
Norwich, CT 06360-4128
Phone
(860) 889-0222
Fax
(860) 889-7997
NPI assigned
Jun 6, 2007
Last updated
Jul 20, 2007By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2007

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

Authorized official

Name
Dr. Altaf Rasool
Title
Owner
Phone
(860) 889-0222

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X 034177 CT
Nephrology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RN0300X 034177 CT Primary

Addresses

Primary practice location

119 Sachem St
Norwich, CT 06360-4128

Mailing address

119 Sachem St
Norwich, CT 06360-4128
Phone (860) 889-0222

National Provider Directory

National Provider Directory

Locations

12 Case St
Ste 305
Norwich, CT 06360
Phone (203) 598-8252

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": "1181088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1184889600000",
    "number": "1679776876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 SACHEM ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063604128",
            "telephone_number": "860-889-0222",
            "fax_number": "860-889-7997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 SACHEM ST",
            "city": "NORWICH",
            "state": "CT",
            "postal_code": "063604128",
            "telephone_number": "860-889-0222",
            "fax_number": "860-889-7997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERNAL MEDICINE ASSOCIATES OF NORWICH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-06",
        "last_updated": "2007-07-20",
        "status": "A",
        "authorized_official_last_name": "RASOOL",
        "authorized_official_first_name": "ALTAF",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-889-0222",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "034177",
            "primary": false
        },
        {
            "code": "207RN0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Nephrology",
            "state": "CT",
            "license": "034177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwich, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 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.