CT Comprehensive Neurologic Management, LLC

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

037501 Issued in CT

Legal business name

CT COMPREHENSIVE NEUROLOGIC MANAGEMENT, LLC

Practice address

2 Broadway
North Haven, CT 06473-2349

Phone

(203) 234-1993

Fax

(203) 234-7147

NPI assigned

Sep 21, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Rosalie G. Mednick

Title

Office Manager

Phone

(203) 234-1993

Specialties & licenses 1

Addresses

Other identifiers 7

Locations

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1277078400000",
    "number": "1730288697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 BROADWAY",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732349",
            "telephone_number": "203-234-1993",
            "fax_number": "203-234-7147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 BROADWAY",
            "city": "NORTH HAVEN",
            "state": "CT",
            "postal_code": "064732349",
            "telephone_number": "203-234-1993",
            "fax_number": "203-234-7147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CT COMPREHENSIVE NEUROLOGIC MANAGEMENT, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-21",
        "last_updated": "2010-06-21",
        "status": "A",
        "authorized_official_last_name": "MEDNICK",
        "authorized_official_first_name": "ROSALIE",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "203-234-1993",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CT",
            "license": "037501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHNET",
            "identifier": "0Q3637",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "3223587",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2491200",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "317063",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9794136003",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "010037501CT02",
            "state": "CT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CONNECTICARE",
            "identifier": "772945",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Neurology Physician in North Haven, CT
• Providers in North Haven, CT by specialty
• Neurology Physician in Connecticut

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