Provider Demographics
NPI:1093904625
Name:PETER T. NAIMAN MD LLC
Entity Type:Organization
Organization Name:PETER T. NAIMAN MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:PETER
Authorized Official - Middle Name:T
Authorized Official - Last Name:NAIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-877-4206
Mailing Address - Street 1:831 BOSTON POST RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3536
Mailing Address - Country:US
Mailing Address - Phone:203-877-4206
Mailing Address - Fax:203-878-4666
Practice Address - Street 1:831 BOSTON POST RD
Practice Address - Street 2:SUITE 201
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3536
Practice Address - Country:US
Practice Address - Phone:203-877-4206
Practice Address - Fax:203-878-4666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-19
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT14322207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTB38926Medicare UPIN
CT200001089Medicare PIN