| Dr Naheed Asad Van De Walle, MD | |
|
111 Salem Tpke, Norwich, CT 06360-7403 | |
| (860) 972-5107 | |
| Not Available |
| Full Name | Dr Naheed Asad Van De Walle |
|---|---|
| Gender | Female |
| Speciality | Physical Medicine & Rehabilitation |
| Location | 111 Salem Tpke, Norwich, Connecticut |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760517288 | NPI | - | NPPES |
| 00790496 | Medicaid | NY | |
| 55247 | Other | NY | HIP |
| P2728904 | Other | NY | OXFORD |
| 230152 | Other | NY | WCB |
| 0037004 | Other | NY | GHI |
| A300100661 | Other | NY | PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208100000X | Physical Medicine & Rehabilitation | 154841 (New York) | Secondary |
| 208100000X | Physical Medicine & Rehabilitation | 64242 (Connecticut) | Primary |
| Entity Name | Physical Medicine & Rehabilitation Of Long Island |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003293366 PECOS PAC ID: 4486966157 Enrollment ID: O20150709000313 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Naheed Asad Van De Walle, MD 111 Salem Tpke, Norwich, CT 06360-7403 Ph: (860) 972-5107 | Dr Naheed Asad Van De Walle, MD 111 Salem Tpke, Norwich, CT 06360-7403 Ph: (860) 972-5107 |
Mr. Gaurav Kapur, MD Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 326 Washington St, Norwich, CT 06360 Phone: 860-889-8331 | |
Alaric Justin-paul Gee, DO Physical Medicine & Rehabilitation Medicare: Accepting Medicare Assignments Practice Location: 111 Salem Tpke Ste 1, Norwich, CT 06360 Phone: 860-972-5107 |