Provider Demographics
NPI:1376649327
Name:ASSOCIATES IN INTERNAL MEDICINE
Entity Type:Organization
Organization Name:ASSOCIATES IN INTERNAL MEDICINE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RN
Authorized Official - Prefix:MRS
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:RESNICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:203-261-2010
Mailing Address - Street 1:965 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-4566
Mailing Address - Country:US
Mailing Address - Phone:203-261-2010
Mailing Address - Fax:203-261-2018
Practice Address - Street 1:965 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-4566
Practice Address - Country:US
Practice Address - Phone:203-261-2010
Practice Address - Fax:203-261-2018
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2010-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001237579-02Medicaid
CT001255886Medicaid
110007352Medicare ID - Type Unspecified
CT001255886Medicaid
E28444Medicare UPIN
E28110Medicare UPIN