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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

EZZA WASIM M.D.
NPI 1215623137
Internal Medicine in New London, CT

Active since April 13, 2023
365 MONTAUK AVE, NEW LONDON, CT 06320(860) 442-0711 Get Directions Write a Review

NPPES record last updated: August 11, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

Record update history: Aug 11, 2026, Apr 13, 2023 (2 updates tracked since 2023).

About Ezza Wasim M.d. NPPES

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

EZZA WASIM M.D. (NPI 1215623137) is an individual internal medicine provider in New London, Connecticut, licensed in Connecticut (83774) and active in the NPI registry since April 2023. She maintains a secondary practice location in Pittsburgh.

NPPES Registry Identity

NPI1215623137
Entity TypeIndividualFemale
Primary Taxonomy207R00000X
Provider Legal NameEZZA WASIMCredential: M.D.
Location Address365 MONTAUK AVENew London, CT 06320-4700
Mailing Address365 Montauk AveNew London, CT 06320-4700
Phone(860) 442-0711
Sole ProprietorNo
Enumeration DateApril 13, 2023
Last NPPES UpdateAugust 11, 20262 updates tracked since enumeration
NPPES CertifiedAugust 11, 2026
✔ NPI 1215623137 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in CT · 83774
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 ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
365 MONTAUK AVE, New London, CT 06320
Open in Google Maps ↗

Secondary Practice Location 1

Location 11400 Locust Street, Suite 10517Pittsburgh, PA 15219-5166 · Phone (412) 232-4065 · Fax (412) 232-5689

Other Providers at the Same Location NPPES 20

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

KATHLEEN M PACHECO RN, CDE
Registered Nurse (Diabetes Educator)
365 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 444-4737
DR. CHRISTOPHER TUDOR OPRICA PHARM.D.
Pharmacist (Pharmacotherapy)
365 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 444-3711
THERESA M. BONANOMI
Social Worker (Clinical)
365 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 444-5141
AMIT KHANNA MD
Family Medicine (Sleep Medicine)
365 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 442-0711
JOANN DONNEL LNM
Advanced Practice Midwife
365 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 442-0711
SAMUEL MARYLES MD
Emergency Medicine
365 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (330) 493-4443
DR. PAUL CASINELLI M.D
Anesthesiology
365 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 442-0711
MARIAM F. ABOUKAR D.O.
Psychiatry & Neurology (Psychiatry)
365 MONTAUK AVE
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 442-0711

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 Ezza Wasim's NPI number?

The NPI number for Ezza Wasim is 1215623137. It was assigned to this individual provider in the NPPES registry on April 13, 2023.

Where is Ezza Wasim located?

Ezza Wasim practices at 365 Montauk Ave, New London, CT 06320. The listed phone number is (860) 442-0711.

What is Ezza Wasim's specialty?

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

When was this NPI record last updated?

The NPPES record for Ezza Wasim was last updated on August 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 26 days 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.