Provider Demographics
NPI:1275718777
Name:QUINNIPIAC INTERNAL MEDICINE PC
Entity Type:Organization
Organization Name:QUINNIPIAC INTERNAL MEDICINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, CEO
Authorized Official - Prefix:
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:
Authorized Official - Last Name:RIPPEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-287-7500
Mailing Address - Street 1:1952 WHITNEY AVE
Mailing Address - Street 2:
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06517-1209
Mailing Address - Country:US
Mailing Address - Phone:203-287-7500
Mailing Address - Fax:203-287-7509
Practice Address - Street 1:1952 WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06517-1209
Practice Address - Country:US
Practice Address - Phone:203-287-7500
Practice Address - Fax:203-287-7509
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2020-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT033256207R00000X
CT005600363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult HealthGroup - Single Specialty