Alliance Medical Group of Greater Waterbury PC
Organization Active NPI Internal Medicine Physician · Middlebury, CT
NPI 1750306015 · NPPES record last updated Sep 3, 2009
Key facts
- NPI
- 1750306015
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Internal Medicine Physician 207R00000X
- Legal business name
- ALLIANCE MEDICAL GROUP OF GREATER WATERBURY PC
- Practice address
- 1625 Straits Tpke
Middlebury, CT 06762-1836 - Phone
- (203) 573-9512
- Fax
- (203) 568-2904
- NPI assigned
- Jul 13, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Mark Aresco
- Title
- President
- Phone
- (203) 573-9512
Practitioners 39
-
Kevin Matthew Baran, M.D., M.P.H.
-
Daniel G. Brennan, DMD
-
Deborah L Casey, MD
-
Shiven B Chabria, MD
-
Ayesha Chaudhry, MD
-
Vincent D. D'Agostino, DMD, MAGD
-
Michael Harma, MD
-
Paul Harvill, MD
-
Jonathan E Hasson, M.D., P.A.
-
Stephen R Holt, M.D.
-
Jay D Kenkare, MD
-
Yasmine S Khan, MD
-
Scott Kurtzman, MD
-
Jock D Lawrason, MD
-
Linda T Mathew, MD
-
Laurie Garnett MC Anaspie, PHYSICIAN ASSISTANT
-
William D Rifkin, MD
-
Lisa Sanders, MD
National Provider Directory
Locations
170 Grandview Ave
Ste 101
Waterbury, CT 06708
Phone (203) 573-7109
40 Main St N
Woodbury, CT 06798
Phone (203) 266-0080
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | |||
| Internal Medicine Physician |
207R00000X | Yes | ||
| Endocrinology, Diabetes & Metabolism Physician |
207RE0101X | |||
| Infectious Disease Physician |
207RI0200X | |||
| Pulmonary Disease Physician |
207RP1001X | |||
| Rheumatology Physician |
207RR0500X | |||
| Pediatrics Physician |
208000000X | |||
| Surgery Physician |
208600000X | |||
| Vascular Surgery Physician |
2086S0129X | |||
| Hospitalist Physician |
208M00000X | |||
| Medical Physician Assistant |
363AM0700X | |||
| Adult Health Nurse Practitioner |
363LA2200X | |||
| Family Nurse Practitioner |
363LF0000X | |||
| Gerontology Nurse Practitioner |
363LG0600X | |||
| Pediatric Nurse Practitioner |
363LP0200X |
Addresses
Primary practice location
1625 Straits Tpke
Middlebury, CT 06762-1836
Mailing address
1625 Straits Tpke
Suite #301
Middlebury, CT 06762-1836
Phone (203) 573-9512
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 004213005 | Medicaid | CT | |
| 004263977 | Medicaid | CT | |
| 004203056 | Medicaid | CT | |
| 004213013 | Medicaid | CT | |
| 004167872 | Medicaid | CT |
Other providers in Middlebury, CT
- Advance Birth to Three
- Advance Therapy Associates
- James Joseph Aglio III
- Albert a. Cantito, D.C. PC
- Joshua Meir Alge
- Alliance Medical Group, Inc
- Taylor Alves
- Anchor Clinical Solutions, LLC
- Janet Lynn Anderson-Ray
- Michelle L Andrews
All providers in Middlebury, CT · Internal Medicine Physician in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 3, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.