City of New London

Primary specialty

Land AmbulanceTaxonomy code 3416L0300X

Legal business name

CITY OF NEW LONDON

Practice address

289 Bank St
New London, CT 06320-5521

Phone

(860) 447-5291

NPI assigned

Sep 19, 2005

Organization subpart

No

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

Authorized official

Name

Ron Samul

Title

Chief

Phone

(860) 447-5291

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1285027200000",
    "number": "1689669384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "269 MAIN ST",
            "city": "CROMWELL",
            "state": "CT",
            "postal_code": "064162302",
            "telephone_number": "860-638-1800",
            "fax_number": "860-638-1802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "289 BANK ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205521",
            "telephone_number": "860-447-5291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY OF NEW LONDON",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-19",
        "last_updated": "2010-09-21",
        "status": "A",
        "authorized_official_last_name": "SAMUL",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "CHIEF",
        "authorized_official_telephone_number": "860-447-5291"
    },
    "taxonomies": [
        {
            "code": "3416L0300X",
            "taxonomy_group": "",
            "desc": "Ambulance, Land Transport",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004072500",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/BLUE SHIELD",
            "identifier": "710C095A2CT01",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "CT0476",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "590069399",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Melissa Marie Chuongvan-Roy, MD
• Katherine Cichon, LPC
• Kenneth Peter Cikatz, RPH
• Kellie S Cirillo, MSW, LCSW
• Brett V Citarella, MD
• Christopher Brett Clark, D.M.D.
• Sean Clark, HS1
• Holden E Clauson, D.D.S.
• Coastal Connecticut Research LLC
• Coastal Digestive Care Center LLC

• Land Ambulance in New London, CT
• Providers in New London, CT by specialty
• Land Ambulance in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2010; 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.