Organization Active NPI

Medical Oncology & Hematology PC

  • Clinical Medical Laboratory
  • Derby, CT
National Provider Identifier
1710071857
Registry record updated Mar 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Medical LaboratoryTaxonomy code 291U00000X
License
CL0459 Issued in CT
Legal business name
MEDICAL ONCOLOGY & HEMATOLOGY PC
Practice address
350 Seymour Ave
Suite 6
Derby, CT 06418-1338
Phone
(203) 734-1664
Fax
(203) 734-1665
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2009

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

Authorized official

Name
Ms. Cynthia A Waranowicz
Title
Ceo
Phone
(203) 389-7504

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Medical Laboratory 291U00000X CL0459 CT Primary

Addresses

Primary practice location

350 Seymour Ave
Suite 6
Derby, CT 06418-1338

Mailing address

19 Lunar Drive
Medical Oncology and Hematology PC
Woodbridge, CT 06525
Phone (203) 389-7504

Other identifiers 2

IdentifierTypeStateIssuer
CL0459OtherCTDEPT OF PUBLIC HEALTH LIC
07D0095888OtherCTCLIA CMS

Other names 1

  • Diagnostic Hematology Lab Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1237766400000",
    "number": "1710071857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19 LUNAR DRIVE",
            "address_2": "MEDICAL ONCOLOGY AND HEMATOLOGY PC",
            "city": "WOODBRIDGE",
            "state": "CT",
            "postal_code": "06525",
            "telephone_number": "203-389-7504",
            "fax_number": "203-389-1666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 SEYMOUR AVE",
            "address_2": "SUITE 6",
            "city": "DERBY",
            "state": "CT",
            "postal_code": "064181338",
            "telephone_number": "203-734-1664",
            "fax_number": "203-734-1665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL ONCOLOGY & HEMATOLOGY PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2009-03-23",
        "status": "A",
        "authorized_official_last_name": "WARANOWICZ",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "203-389-7504",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": "CT",
            "license": "CL0459",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DEPT OF PUBLIC HEALTH LIC",
            "identifier": "CL0459",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA CMS",
            "identifier": "07D0095888",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Diagnostic Hematology Lab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Derby, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2009; 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.