EAST GRANBY FAMILY PRACTICE LLC - NPI 1154308229 - Family Medicine in East Granby, CT

Q: What is East Granby Family Practice LLC's NPI number?

The NPI number for East Granby Family Practice LLC is 1154308229. It was assigned to this organization in the NPPES registry on December 29, 2005.

Q: What is East Granby Family Practice LLC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

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About East Granby Family Practice Llc NPPES

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

EAST GRANBY FAMILY PRACTICE LLC (NPI 1154308229) is a healthcare organization registered as a family medicine in East Granby, Connecticut and active in the NPI registry since December 2005. The organization holds a CLIA Microscopy certificate valid through May 12, 2027 and lists Steven R Dietrich, Partner Md, as its authorized official.

NPPES Registry Identity

NPI1154308229

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NameEAST GRANBY FAMILY PRACTICE LLC

Location Address13 CHURCH RDEast Granby, CT 06026-0518

Mailing Address13 Church Rd, Po Box 518East Granby, CT 06026-0518 · (860) 653-4526 · Fax (860) 653-5209

Phone(860) 653-4526

Fax(860) 653-5209

Organization SubpartNo

Authorized OfficialSteven R DietrichPartner Md · (860) 653-4526

Enumeration DateDecember 29, 2005

Last NPPES UpdateJune 26, 2013

✔ NPI 1154308229 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X

13 CHURCH RD, East Granby, CT 06026

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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 for Provider-Performed Microscopy Procedures (PPMP) 07D0092457

East Granby Family Practice LLC · East Granby, CT

Active · expires May 12, 2027

CLIA Number07D0092457

Laboratory TypePhysician Office

Certificate Effective DateMay 13, 2025

Certificate Expiration DateMay 12, 2027

Laboratory DirectorDavid R. Howlett

Laboratory Phone(203) 653-4526

Laboratory LocationEast Granby Family Practice LLC13 Church Road, East Granby, CT 06026

CLIA data matches this NPI record on: Address Name

This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 13

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

STEVEN R DIETERICH MD

Family Medicine