INTERNAL MEDICINE OF WESTHAVEN, LLC NPI 1003005703

Internal Medicine in West Haven, CT

NPI 1003005703 Organization Internal Medicine CLIA Number 07D1008034 CLIA Certificate of Waiver

About INTERNAL MEDICINE OF WESTHAVEN, LLC

Internal Medicine Of Westhaven,llc is an internal medicine provider established in West Haven, Connecticut specializing in internal medicine. The NPI number of Internal Medicine Of Westhaven,llc is 1003005703 and was assigned on October 2007. The practitioner's primary taxonomy code is 207R00000X with license number 035984 (CT). The provider is registered as an organization and their NPI record was last updated 14 years ago. Internal Medicine Of Westhaven,llc operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The authorized official of this NPI record is Dr. Sreedhar R Gottiparthy M.d (Phisician)

An internist like Internal Medicine Of Westhaven,llc is a physician who has completed an internal medicine residency and is board-certified or board-eligible in an internist specialty. Internists are trained to care for adults of all ages for many different medical conditions. An internist typically monitors chronic physical conditions, identifies acute diseases, provides family planning, provides counseling about wellness and disease prevention, etc.

The CLIA number of Internal Medicine Of Westhaven,llc is 07D1008034 registered as a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to Internal Medicine Of Westhaven,llc to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.

NPI

1003005703

Provider NameINTERNAL MEDICINE OF WESTHAVEN,LLC
Provider Location Address764 CAMPBELL AVE SUITE E WEST HAVEN, CT 06516
Provider Mailing Address764 CAMPBELL AVE WEST HAVEN, CT 06516
NPI Entity TypeOrganization
Is Sole Proprietor?N/A
Is Organization Subpart?No
Enumeration Date10-18-2007
Last Update Date10-18-2007


Primary Taxonomy

Taxonomy Code207R00000X
ClassificationInternal Medicine
TypeAllopathic & Osteopathic Physicians
License No.035984
License StateCT
Taxonomy DescriptionA physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Business Address

INTERNAL MEDICINE OF WESTHAVEN,LLC
764 CAMPBELL AVE
SUITE E
WEST HAVEN, CT
ZIP 06516
Phone: (203) 931-0034
Fax: (203) 931-8225

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Mailing Address

INTERNAL MEDICINE OF WESTHAVEN,LLC
764 CAMPBELL AVE
WEST HAVEN, CT
ZIP 06516
Phone: (203) 931-0034
Fax: (203) 931-8225



Authorized Official

Authorized Official NameDR. SREEDHAR R GOTTIPARTHY M.D
Authorized Official TitlePHISICIAN
Authorized Official Phone(203) 931-0034

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for the NPI number 1003005703 is:

CLIA Number07D1008034
Facility TypePHYSICIAN OFFICE
Certificate TypeCertificate of Waiver

Group Taxonomy


193400000X SINGLE SPECIALTY GROUP - This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Other Providers at the same location


The following 7 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1861622474PHYSICAL THERAPY & REHABILITATION CENTER LLC
Organization
Physical Therapist764 CAMPBELL AVE SUITE H
WEST HAVEN, CT 06516
(203) 909-6470
1619991981 SEAN WAYNE LAZARUS D.P.M
Individual
Podiatrist764 CAMPBELL AVE SUITE G
WEST HAVEN, CT 06516
(475) 238-7400
1679680391DR. NKEMAKONAM H IKEKPEAZU MD
Individual
Surgery764 CAMPBELL AVE
WEST HAVEN, CT 06516
(203) 937-8778
1629430251 SANDHYA JINESH
Individual
Pharmacist764 CAMPBELL AVE UNIT A
WEST HAVEN, CT 06516
(203) 934-7100
1881180222DR. EYMY DIANA CHACON APRN
Individual
Nurse Practitioner (Family)764 CAMPBELL AVE
WEST HAVEN, CT 06516
(203) 931-0034
1437561990WEST HAVEN PHARMACY, LLC
Organization
Pharmacy (Community/Retail Pharmacy)764 CAMPBELL AVE
WEST HAVEN, CT 06516
(203) 974-7100
1710651005DR. BRITTANY MARY ZARRELLA DNP, APRN, FNP-C
Individual
Nurse Practitioner (Family)764 CAMPBELL AVE
WEST HAVEN, CT 06516
(203) 931-0034

NPI Footnotes

What is the National Provider Indentifier (NPI)?
The NPI is 10-position all-numeric identification number assigned by the NPPES to uniquely identify a health care provider.

Provider Location Address
The location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.

Provider Mailing Address
The mailing address of the provider being identified. This address may contain the same information as the provider location address.

Entity Type Code
The code describing the type of health care provider that is being assigned an NPI.
The entity type codes are:
1 = Person: individual human being who furnishes health care;
2 = Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)

What is a Subpart?
Subparts are the components and separate physical locations of organization health care providers. Subpart examples include:
Hospital components include outpatient departments, surgical centers, psychiatric units, and laboratories. These components are often separately licensed or certified by States and may exist at physical locations other than that of the hospital of which they are a component.

Provider Other Organization Name
The other organization name is the alternative last name by which the provider is or has been known (if an individual) or other name by which the organization provider is or has been known. The code identifying the type of other name. The provider other organization name codes are:
1 = former name;
2 = professional name;
3 = doing business as (d/b/ a) name;
4 = former legal business name; :
5 = other.

Provider Enumeration Date
The date the provider was assigned a unique identifier (assigned an NPI).

Last Update Date
The date that a NPI record was last updated or changed.

Primary Taxonomy Code
The primary taxonomy code defines the provider type, classification, and specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Authorized Official Name
The name of the person authorized to submit the NPI application or to officially change data for a health care provider.