SF Connecticut Medical Services PC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

SF CONNECTICUT MEDICAL SERVICES PC

Practice address

2798 Whitney Ave
Hamden, CT 06518-2554

Phone

(877) 258-6331

Fax

(718) 414-1651

NPI assigned

Mar 9, 2019

Last updated

Jan 19, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Simon Fensterszaub, DONPI 1003077322

Title

Owner

Phone

(212) 734-6621

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Simon Fensterszaub, D.O.

  • Family Medicine Physician
  • Bristol, RI
  • NPI 1003077322

  MO

  Medicare reassignment Authorized official

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

{
    "created_epoch": "1552089600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1674086400000",
    "number": "1841758729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "228 E ROUTE 59 # 408",
            "city": "NANUET",
            "state": "NY",
            "postal_code": "109542905",
            "telephone_number": "718-362-1411",
            "fax_number": "718-414-1651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2798 WHITNEY AVE",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065182554",
            "telephone_number": "877-258-6331",
            "fax_number": "718-414-1651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SF CONNECTICUT MEDICAL SERVICES PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-09",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A",
        "authorized_official_last_name": "FENSTERSZAUB",
        "authorized_official_first_name": "SIMON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "212-734-6621",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "62202",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jacqueline S Servidio, LCSW
• Suzanne Serviss, LCSW
• Marley Anderson Sessa, OTR/L
• Lynne Severance, APRN
• Lorna M Seybolt, MD
• Jalpaben Abhishek Shah
• Purvi Deepak Shah, PH.D.
• Shahin Shaikh, PA-C
• Maria R Shanley, RPT
• David Shapera, PHARMD

• Family Medicine Physician in Hamden, CT
• Providers in Hamden, CT by specialty
• Family Medicine Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.