Geriatric Professional Group, LLC

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

Legal business name

GERIATRIC PROFESSIONAL GROUP, LLC

Practice address

4200 Park Ave
Bridgeport, CT 06604-1049

Phone

(203) 365-6473

Fax

(203) 396-1039

NPI assigned

Oct 5, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Andrew H Banoff

Title

President/Ceo

Phone

(203) 365-6400

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CT

Enrollment records 1

Locations

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph Frederick Fickes, MD

  • Psychiatry Physician
  • Fairfield, CT
  • NPI 1902838329
  Medicare reassignment NPD
• Kenneth C Fine, MD

  • Internal Medicine Physician
  • Fairfield, CT
  • NPI 1063508349
  Medicare reassignment NPD
• Vittoria Gassman, MD

  • Internal Medicine Physician
  • Norwalk, CT
  • NPI 1013987700
  Medicare reassignment NPD
• Pamela Hoffman, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Bridgeport, CT
  • NPI 1366548778
  Medicare reassignment NPD
• Allison Margold Ostroff, M.D.

  • Internal Medicine Physician
  • Greenwich, CT
  • NPI 1720262397
  Medicare reassignment NPD
• Randi Diamond, M.D.

  • Geriatric Medicine (Internal Medicine) Physician
  • New York, NY
  • NPI 1700946472

  CT

  Medicare reassignment NPD
• Tara Seiler

  • Certified Registered Nurse Anesthetist
  • Bridgeport, CT
  • NPI 1023094380
  NPD (past)

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

{
    "created_epoch": "1160006400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478476800000",
    "number": "1932295953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4200 PARK AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066041049",
            "telephone_number": "203-365-6473",
            "fax_number": "203-396-1039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4200 PARK AVE",
            "city": "BRIDGEPORT",
            "state": "CT",
            "postal_code": "066041049",
            "telephone_number": "203-365-6473",
            "fax_number": "203-396-1039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERIATRIC PROFESSIONAL GROUP, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-05",
        "last_updated": "2016-11-07",
        "status": "A",
        "authorized_official_last_name": "BANOFF",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "203-365-6400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "CT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9233",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marcia Georges
• Smyralda Georges, BS
• Katina Louise Georgopulo, LMSW
• Gerald Micalizzi, M.D., LLC
• Patricia Julianne Gerety, HIS
• Debra Gerson, MD
• Richard Jay Gessman, M.D., PH.D.
• Stephanie Gesualdi
• Jaime Geter, CRNA
• Getting Better Counseling Services, LLC

• Internal Medicine Physician in Bridgeport, CT
• Providers in Bridgeport, 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 Nov 7, 2016; 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.