Individual provider Active NPI

Elizabeth B Muskin, MD

  • Internal Medicine Physician
  • New Haven, CT
National Provider Identifier
1881694669
Registry record updated Apr 25, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
031088 Issued in CT
Practice address
55 Lock Street
New Haven, CT 06520-8237
Phone
(203) 432-0076
Fax
(203) 432-7289
NPI assigned
Jul 22, 2005
Reactivated
Mar 27, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 031088 CT Primary

Addresses

Primary practice location

55 Lock Street
New Haven, CT 06520-8237

Mailing address

55 Lock Street
PO Box 208237
New Haven, CT 06520-8237
Phone (203) 432-0076

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
031088CTMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Shoreline Internal Medicine, LLC Internal Medicine PastSince Jan 5, 2009 Accepting new patients
Northeast Medical Group, Inc. Internal Medicine Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1121990400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303689600000",
    "number": "1881694669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 LOCK STREET",
            "address_2": "PO BOX 208237",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208237",
            "telephone_number": "203-432-0076",
            "fax_number": "203-432-7289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 LOCK STREET",
            "city": "NEW HAVEN",
            "state": "CT",
            "postal_code": "065208237",
            "telephone_number": "203-432-0076",
            "fax_number": "203-432-7289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MUSKIN",
        "first_name": "ELIZABETH",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-22",
        "last_updated": "2011-04-25",
        "deactivation_date": "2006-03-21",
        "reactivation_date": "2006-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "031088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Haven, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2011; 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.