Coastal Behavioral Health

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

Legal business name

COASTAL BEHAVIORAL HEALTH

Practice address

567 Vauxhall Street Ext
Suite 118
Waterford, CT 06385-4330

Phone

(860) 444-0503

Fax

(860) 444-0504

NPI assigned

Jul 27, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Martin Jude Maloney, DONPI 1588629679

Title

Owner

Phone

(860) 444-0503

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Martin Jude Maloney, DO

  • Psychiatry Physician
  • Norwich, CT
  • NPI 1588629679
  NPD (past) Authorized official

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

{
    "created_epoch": "1153958400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376956800000",
    "number": "1750305231",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "567 VAUXHALL STREET EXT",
            "address_2": "SUITE 118",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063854330",
            "telephone_number": "860-444-0503",
            "fax_number": "860-444-0504"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "567 VAUXHALL STREET EXT",
            "address_2": "SUITE 118",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063854330",
            "telephone_number": "860-444-0503",
            "fax_number": "860-444-0504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COASTAL BEHAVIORAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-27",
        "last_updated": "2013-08-20",
        "status": "A",
        "authorized_official_last_name": "MALONEY",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_middle_name": "JUDE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "860-444-0503",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatry Physician in Waterford, CT
• Providers in Waterford, CT by specialty
• Psychiatry Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2013; 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.