Provider Demographics
NPI:1376574947
Name:INTERNAL MEDICINE ASSOCIATES OF DARIEN, P.C.
Entity Type:Organization
Organization Name:INTERNAL MEDICINE ASSOCIATES OF DARIEN, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:PHILIP
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:NEGUS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:203-655-4484
Mailing Address - Street 1:36 OLD KINGS HWY S
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DARIEN
Mailing Address - State:CT
Mailing Address - Zip Code:06820-4523
Mailing Address - Country:US
Mailing Address - Phone:203-655-4484
Mailing Address - Fax:203-656-0701
Practice Address - Street 1:36 OLD KINGS HWY S
Practice Address - Street 2:SUITE 200
Practice Address - City:DARIEN
Practice Address - State:CT
Practice Address - Zip Code:06820-4523
Practice Address - Country:US
Practice Address - Phone:203-655-4484
Practice Address - Fax:203-656-0701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2010-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001222256Medicaid
CT001396614Medicaid
CT001355785Medicaid
CT110171891OtherRAILROAD MEDICARE PROVIDE
CT110220758OtherRAILROAD MEDICARE PROVIDE
CT001172683Medicaid
CT001236066Medicaid
CT110144792OtherRAILROAD MEDICARE PROVIDE
CT110218045OtherRAILROAD MEDICARE NUMBER
CT001222256Medicaid
CT110144792OtherRAILROAD MEDICARE PROVIDE
CTB38347Medicare UPIN
CTB39492Medicare UPIN
CTG41246Medicare UPIN
CT110006558Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CT110001470Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CT110008298Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
CT110220758OtherRAILROAD MEDICARE PROVIDE
CTA61714Medicare UPIN
CT001236066Medicaid