| Family Practice & Internal Medicine, Llc | |
|
52 Washington Ave Suite 4 North Haven CT 06473-1724 | |
| (203) 672-2800 | |
| (203) 672-2801 |
| Full Name | Family Practice & Internal Medicine, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 52 Washington Ave, North Haven, Connecticut |
| Authorized Official Name and Position | Fausto Petruzziello (OWNER) |
| Authorized Official Contact | 2036722800 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Family Practice & Internal Medicine, Llc 52 Washington Ave Suite 4 North Haven CT 06473-1724 Ph: (203) 672-2800 | Family Practice & Internal Medicine, Llc 52 Washington Ave Suite 4 North Haven CT 06473-1724 Ph: (203) 672-2800 |
| NPI Number | 1902095003 |
|---|---|
| Provider Enumeration Date | 10/15/2007 |
| Last Update Date | 05/31/2012 |
| Medicare PECOS PAC ID | 5991894123 |
|---|---|
| Medicare Enrollment ID | O20071211000192 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1902095003 | NPI | - | NPPES |
| 500000049 | Medicaid | CT | |
| DG5581 | Other | CT | RAILROAD MEDICARE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Renu Bazaz-kapoor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1427045954 PECOS PAC ID: 3678463841 Enrollment ID: I20040319000509 |
| Provider Name | Fausto Petruzziello |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316933419 PECOS PAC ID: 0345139630 Enrollment ID: I20071211000250 |
| Provider Name | Randolph Ramirez |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629178843 PECOS PAC ID: 7517118748 Enrollment ID: I20121115000195 |
| Provider Name | Osama Kandalaft |
|---|---|
| Provider Type | Practitioner - Hospitalist |
| Provider Identifiers | NPI Number: 1063868065 PECOS PAC ID: 6608160809 Enrollment ID: I20190827002194 |
| Provider Name | Alexandria K Koukos |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1205608619 PECOS PAC ID: 8123477643 Enrollment ID: I20231209000151 |
Medical Associates Of North Haven Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 100 Broadway, North Haven, CT 06473 Phone: 203-234-1891 Fax: 203-234-7037 | |
Continuum Medical Group, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 163 Universal Dr N, North Haven, CT 06473 Phone: 203-466-8060 Fax: 203-907-3279 | |
Village Medical Associates, P.c. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12 Village Street, Suite 5, North Haven, CT 06473 Phone: 203-865-6400 Fax: 203-865-8600 | |
Epic Family Physicians, Llp Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 163 Universal Dr N, North Haven, CT 06473 Phone: 203-298-4600 Fax: 203-907-3272 | |
Primary Care Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 352 State St, North Haven, CT 06473 Phone: 203-781-4600 Fax: 203-781-4624 | |
Discovery Health & Wellness Center, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 State St, North Haven, CT 06473 Phone: 203-787-8233 | |
Apex Medical Associates, Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 12 Village St, North Haven, CT 06473 Phone: 203-865-6400 Fax: 203-865-0195 |