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INTERNAL MEDICINE OF WEST HAVEN LLC
NPI 1003005703
Internal Medicine in West Haven, CT

Active since October 18, 2007CLIA 07D1008034 · Waiver
764 CAMPBELL AVE, SUITE E, WEST HAVEN, CT 06516(203) 931-0034(203) 931-8225 Get Directions Write a Review

NPPES record last updated: February 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Feb 11, 2025, Feb 6, 2025, Apr 3, 2024 and 4 more (7 updates tracked since 2023).

About Internal Medicine Of West Haven Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INTERNAL MEDICINE OF WEST HAVEN LLC (NPI 1003005703) is a healthcare organization registered as an internal medicine in West Haven, Connecticut and active in the NPI registry since October 2007. The organization holds a CLIA Waiver certificate valid through January 8, 2027, maintains a secondary practice location in Avon, and lists Marizelle Flores, Credentialing Manager, as its authorized official.

NPPES Registry Identity

NPI1003005703
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameINTERNAL MEDICINE OF WEST HAVEN LLC
Location Address764 CAMPBELL AVE, SUITE EWest Haven, CT 06516-3786
Mailing Address764 Campbell AveWest Haven, CT 06516-3786 · (203) 931-0034 · Fax (203) 931-8225
Phone(203) 931-0034
Fax(203) 931-8225
Organization SubpartNo
Authorized OfficialMarizelle FloresCredentialing Manager · (860) 944-4766
Enumeration DateOctober 18, 2007
Last NPPES UpdateFebruary 11, 20257 updates tracked since enumeration
NPPES CertifiedFebruary 11, 2025
✔ NPI 1003005703 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A 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.
Also ListedPsychiatry & Neurology · Behavioral Neurology & NeuropsychiatryTaxonomy 2084B0040X
764 CAMPBELL AVE, West Haven, CT 06516
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Secondary Practice Location 1

Location 140 Dale Rd., Ste #202Avon, CT 06001 · Phone (203) 931-0034

Other Identifiers 2

Medicaid008080626CT
Medicaid001359844CT

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 07D1008034

Internal Medicine Of West Haven Ct · West Haven, CT
Active · expires Jan 8, 2027
CLIA Number07D1008034
Laboratory TypePhysician Office
Certificate Effective DateJanuary 9, 2025
Certificate Expiration DateJanuary 8, 2027
Laboratory DirectorSreedhar R. Gottiparthy, MD
Laboratory Phone(203) 931-0034
Laboratory LocationInternal Medicine Of West Haven Ct764 Campbell Avenue, West Haven, CT 06516
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DI YI HE APRN
Nurse Practitioner (Family)
764 CAMPBELL AVE
WEST HAVEN, CT 06516
South Central Connecticut Planning Region (203) 931-0034
WEST HAVEN PHARMACY, LLC
Pharmacy (Community/Retail Pharmacy)
764 CAMPBELL AVE
WEST HAVEN, CT 06516
South Central Connecticut Planning Region (203) 974-7100
SEAN WAYNE LAZARUS D.P.M
Podiatrist
764 CAMPBELL AVE, SUITE G
WEST HAVEN, CT 06516
South Central Connecticut Planning Region (475) 238-7400
SANDHYA JINESH
Pharmacist
764 CAMPBELL AVE, UNIT A
WEST HAVEN, CT 06516
South Central Connecticut Planning Region (203) 934-7100
DR. NKEMAKONAM H IKEKPEAZU MD
Surgery
764 CAMPBELL AVE
WEST HAVEN, CT 06516
South Central Connecticut Planning Region (203) 937-8778
PHYSICAL THERAPY & REHABILITATION CENTER LLC
Physical Therapist
764 CAMPBELL AVE, SUITE H
WEST HAVEN, CT 06516
South Central Connecticut Planning Region (203) 909-6470
DR. EYMY DIANA CHACON APRN
Nurse Practitioner (Family)
764 CAMPBELL AVE
WEST HAVEN, CT 06516
South Central Connecticut Planning Region (203) 931-0034

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Internal Medicine Of West Haven LLC's NPI number?

The NPI number for Internal Medicine Of West Haven LLC is 1003005703. It was assigned to this organization in the NPPES registry on October 18, 2007.

Where is Internal Medicine Of West Haven LLC located?

Internal Medicine Of West Haven LLC is located at 764 Campbell Ave Suite E, West Haven, CT 06516. The listed phone number is (203) 931-0034.

What is Internal Medicine Of West Haven LLC's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Does Internal Medicine Of West Haven LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 07D1008034) is associated with this NPI, valid through January 8, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Internal Medicine Of West Haven LLC was last updated on February 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.