Family Practice of Greater New Haven, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

040951 Issued in CT

Legal business name

FAMILY PRACTICE OF GREATER NEW HAVEN, LLC

Practice address

850 N Main Street Ext
Building 2 Suite 1B
Wallingford, CT 06492-2400

Phone

(203) 269-4200

Fax

(203) 269-8800

NPI assigned

Aug 21, 2006

Last updated

Dec 20, 2007By 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

Dr. Anatoly Braylovsky, M.D.NPI 1023004124

Title

Physician/ Owner

Phone

(203) 269-4200

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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.

• Anatoly Braylovsky, MD

  • Internal Medicine Physician
  • Wallingford, CT
  • NPI 1023004124
  Authorized official Same address or phone

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1198108800000",
    "number": "1922114495",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 N MAIN STREET EXT",
            "address_2": "BUILDING 2 SUITE 1B",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922400",
            "telephone_number": "203-269-4200",
            "fax_number": "203-269-8800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 N MAIN STREET EXT",
            "address_2": "BUILDING 2 SUITE 1B",
            "city": "WALLINGFORD",
            "state": "CT",
            "postal_code": "064922400",
            "telephone_number": "203-269-4200",
            "fax_number": "203-269-8800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY PRACTICE OF GREATER NEW HAVEN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-12-20",
        "status": "A",
        "authorized_official_last_name": "BRAYLOVSKY",
        "authorized_official_first_name": "ANATOLY",
        "authorized_official_title_or_position": "PHYSICIAN/ OWNER",
        "authorized_official_telephone_number": "203-269-4200",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": "040951",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001409516",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eye Health Professionals, P.C.
• Sophia Fagan
• Susan Fagan
• Susan Michelle Fagan, LCSW
• Deborah B Fahs, APRN
• James B Fanning Jr., M.D.
• Alison Jane Farrell, OTR/L
• John Mark Farrell, P.A.
• William Joseph Farrell, M.D.
• Faulkner Physical Therapy Group, Inc.

• Internal Medicine Physician in Wallingford, CT
• Providers in Wallingford, CT by specialty
• Internal Medicine Physician in Connecticut

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