NPIMap

Organization Active NPI

Integrated Medical of Norwalk, LLC

  • Multi-Specialty Clinic/Center
  • Norwalk, CT
National Provider Identifier
1689894735
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
031959 Issued in CT
Legal business name
INTEGRATED MEDICAL OF NORWALK, LLC
Practice address
365 Westport Ave
Norwalk, CT 06851-4344
Phone
(203) 845-0400
Fax
(203) 845-0005
NPI assigned
Apr 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Michael Lance Gerstenfeld, M.D.
Title
Manager
Phone
(203) 845-0400

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X 031959 CT Primary

Addresses

Primary practice location

365 Westport Ave
Norwalk, CT 06851-4344

Mailing address

365 Westport Ave
Norwalk, CT 06851-4344
Phone (203) 845-0400

National Provider Directory

National Provider Directory
Tax ID family
Integrated Medical Center2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1689894735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 WESTPORT AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068514344",
            "telephone_number": "203-845-0400",
            "fax_number": "203-845-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 WESTPORT AVE",
            "city": "NORWALK",
            "state": "CT",
            "postal_code": "068514344",
            "telephone_number": "203-845-0400",
            "fax_number": "203-845-0005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTEGRATED MEDICAL OF NORWALK, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "GERSTENFELD",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "LANCE",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "203-845-0400",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "CT",
            "license": "031959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norwalk, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.