| Ahmad Fotovat, MD | |
|
115 Technology Dr, C-100, Trumbull, CT 06611-1395 | |
| (203) 268-5212 | |
| (203) 268-6779 |
| Full Name | Ahmad Fotovat |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | 115 Technology Dr, Trumbull, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740234178 | NPI | - | NPPES |
| 4395958 | Other | CT | CIGNA |
| 512H41 | Other | CT | EMPIRE BC/BS |
| 1176502 | Other | CT | AETNA - HMO |
| 2V5317 | Other | CT | HEALTH NET |
| 796029 | Other | CT | CONNECTICARE |
| 4662047 | Other | CT | AETNA - PPO |
| 010022045CT04 | Other | CT | ANTHEM BC/BS |
| 103685 | Other | CT | BETTER HEALTH ADVANTAGE |
| ZS080 | Other | CT | OXFORD HEALTH PLANS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | 022045 (Connecticut) | Primary |
| Entity Name | St. Vincent's Multispecialty Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1043544489 PECOS PAC ID: 6204977218 Enrollment ID: O20100112000538 |
| Mailing Address | Practice Location Address |
|---|---|
| Ahmad Fotovat, MD 115 Technology Dr, C-100, Trumbull, CT 06611-6337 Ph: (203) 268-5212 | Ahmad Fotovat, MD 115 Technology Dr, C-100, Trumbull, CT 06611-1395 Ph: (203) 268-5212 |
Noah Solomon Kinstlinger, M.D. Surgery Medicare: Medicare Enrolled Practice Location: 112 Quarry Rd, Trumbull, CT 06611 Phone: 203-785-2561 | |
Shareef Jandali, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 5520 Park Ave, Suite Wp-2-300, Trumbull, CT 06611 Phone: 203-374-0310 Fax: 203-374-0314 | |
Daniel J Passeri, MD Surgery Medicare: Not Enrolled in Medicare Practice Location: 888 White Plains Rd, Suite 206, Trumbull, CT 06611 Phone: 203-459-8555 Fax: 203-459-2666 | |
Timothy B Ehrlich Ii, M.D. Surgery Medicare: Not Enrolled in Medicare Practice Location: 115 Technology Drive, Suite C100, Trumbull, CT 06611 Phone: 203-899-0744 Fax: 203-268-6779 | |
Melanie A Lynch, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 5520 Park Ave Ste 1-500, Trumbull, CT 06611 Phone: 203-254-2381 Fax: 203-337-8788 |