Greater New Haven ASC, LLC

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

Legal business name

GREATER NEW HAVEN ASC, LLC

Practice address

2080 Whitney Ave Ste 100
Hamden, CT 06518-3603

Phone

(833) 271-4254

Fax

(203) 745-2392

NPI assigned

Nov 8, 2018

Organization subpart

No

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

Authorized official

Name

Mr. Daniel Coraluzzi

Title

Chief Administrative Officer

Phone

(833) 271-4254

Specialties & licenses 1

Addresses

Other names 1

• North East Alliance Surgery Center Doing business as

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Listed as

North East Alliance Surgery CenterCCN 07C0001068

Medicare certification status

ActiveFrom the Provider of Services file

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

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

{
    "created_epoch": "1541635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1541635200000",
    "number": "1922576818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2080 WHITNEY AVE STE 100",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183603",
            "telephone_number": "833-271-4254",
            "fax_number": "203-745-2392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2080 WHITNEY AVE STE 100",
            "city": "HAMDEN",
            "state": "CT",
            "postal_code": "065183603",
            "telephone_number": "833-271-4254",
            "fax_number": "203-745-2392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER NEW HAVEN ASC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-08",
        "last_updated": "2018-11-08",
        "status": "A",
        "authorized_official_last_name": "CORALUZZI",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "CHIEF ADMINISTRATIVE OFFICER",
        "authorized_official_telephone_number": "833-271-4254",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "North East Alliance Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Abiola J Grant
• Destiny R. Grant, N.D., APRN
• Tamara Grant, LCSW
• Leonard E Grauer, MD
• Ronisha Nicole Gray
• Greater New Haven Counseling and Family Therapy Center, LLP
• Blerta Green, M.D.
• Cheryl Ann Green, LCSW
• Rebecca Greenberg, POSTPARTUM DOULA
• Les R Greene, PHD

• Ambulatory Surgical Clinic/Center in Hamden, CT
• Providers in Hamden, CT by specialty
• Ambulatory Surgical Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.