Gold Coast Pulmonary and Sleep Associates, LLC

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

000413 Issued in CT

Legal business name

GOLD COAST PULMONARY AND SLEEP ASSOCIATES, LLC

Practice address

492 Montauk Ave
New London, CT 06320-4615

Phone

(860) 443-0305

Fax

(860) 444-0823

NPI assigned

Sep 29, 2006

Organization subpart

No

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

Authorized official

Name

Dr. Paul Justin Licata, D.O.

Title

Owner/Physician

Phone

(860) 443-0305

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1159488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1196640000000",
    "number": "1821180621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "492 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204615",
            "telephone_number": "860-443-0305",
            "fax_number": "860-444-0823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "492 MONTAUK AVE",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063204615",
            "telephone_number": "860-443-0305",
            "fax_number": "860-444-0823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOLD COAST PULMONARY AND SLEEP ASSOCIATES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-29",
        "last_updated": "2007-12-03",
        "status": "A",
        "authorized_official_last_name": "LICATA",
        "authorized_official_first_name": "PAUL",
        "authorized_official_middle_name": "JUSTIN",
        "authorized_official_title_or_position": "OWNER/PHYSICIAN",
        "authorized_official_telephone_number": "860-443-0305",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.O."
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "CT",
            "license": "000413",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM GROUP NUMBER",
            "identifier": "50GOLDCOACT01",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nancy Robin Gluckcoleman, COTA
• Naomi Gobeille, CISW
• Anna Hazel Goddard, APRN, CPNP-PC
• Adriana Shea Godfrey, FNP-C
• Gold Coast Pulmonary and Sleep Assoc
• Jeffrey Stuart Gold, M.D.
• Bernadette Golden, LMFT
• Sarah Golub, LMSW
• Luis Roberto Gonzalez, MD
• Abigail Goodale, PA-C

• Pulmonary Disease Physician in New London, CT
• Providers in New London, CT by specialty
• Pulmonary Disease Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2007; 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.