| Dr Divya Mamootil, MD | |
|
300 Seymour Ave Ste 203b, Derby, CT 06418-1343 | |
| (203) 516-5303 | |
| (203) 732-8136 |
| Full Name | Dr Divya Mamootil |
|---|---|
| Gender | Female |
| Speciality | Rheumatology |
| Experience | 6 Years |
| Location | 300 Seymour Ave Ste 203b, Derby, Connecticut |
| Accepts Medicare Assignments | May be. She may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1134794050 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RR0500X | Internal Medicine - Rheumatology | 82939 (Connecticut) | Primary |
| 207RR0500X | Internal Medicine - Rheumatology | MT231028 (Pennsylvania) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| St Luke's Hospital Bethlehem | Bethlehem, PA | Hospital |
| Entity Name | Griffin Faculty Physicians Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598755605 PECOS PAC ID: 7618871997 Enrollment ID: O20031120000158 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Divya Mamootil, MD 67 Maple Ave, Derby, CT 06418-1328 Ph: Not Available | Dr Divya Mamootil, MD 300 Seymour Ave Ste 203b, Derby, CT 06418-1343 Ph: (203) 516-5303 |
Dr. William Gray, M.D. Rheumatology Medicare: Medicare Enrolled Practice Location: 130 Division St, Derby, CT 06418 Phone: 203-732-1330 Fax: 203-732-1332 |
Dr. Gerald George Fette, M.D. Rheumatology Medicare: Accepting Medicare Assignments Practice Location: 130 Division St, Derby, CT 06418 Phone: 203-732-1330 Fax: 203-732-1332 |
Dr. Howard Quentzel, M.D. Rheumatology Medicare: Accepting Medicare Assignments Practice Location: 130 Division St, Derby, CT 06418 Phone: 203-732-7439 Fax: 203-732-1425 |
Dr. Mukesh Kumar, MD Rheumatology Medicare: Accepting Medicare Assignments Practice Location: 130 Division St, Derby, CT 06418 Phone: 203-732-1330 Fax: 203-732-1332 |
Ranjit S Chandpuri, MD Rheumatology Medicare: Accepting Medicare Assignments Practice Location: 130 Division St, Derby, CT 06418 Phone: 203-732-1330 Fax: 203-732-1332 |
Mohsin Ali, M.D. Rheumatology Medicare: Accepting Medicare Assignments Practice Location: 130 Division Street, Derby, CT 06418 Phone: 203-732-7327 |
Earl Lewin Baker, MD Rheumatology Medicare: Not Enrolled in Medicare Practice Location: 130 Division Street, Derby, CT 06418 Phone: 203-735-7421 |