Provider Demographics
NPI: | 1467537290 |
---|---|
Name: | STARLING PHYSICIANS, PLLC |
Entity Type: | Organization |
Organization Name: | STARLING PHYSICIANS, PLLC |
Other - Org Name: | STARLING PHYSICIANS, P.C |
Other - Org Type: | Former Legal Business Name |
Authorized Official - Title/Position: | CEO |
Authorized Official - Prefix: | |
Authorized Official - First Name: | JEFFREY |
Authorized Official - Middle Name: | D |
Authorized Official - Last Name: | LEBENGER |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 908-790-6567 |
Mailing Address - Street 1: | PO BOX 587 |
Mailing Address - Street 2: | |
Mailing Address - City: | ROCKY HILL |
Mailing Address - State: | CT |
Mailing Address - Zip Code: | 06067-0587 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 860-258-3480 |
Mailing Address - Fax: | 860-571-6800 |
Practice Address - Street 1: | 2110 SILAS DEANE HWY |
Practice Address - Street 2: | |
Practice Address - City: | ROCKY HILL |
Practice Address - State: | CT |
Practice Address - Zip Code: | 06067-2313 |
Practice Address - Country: | US |
Practice Address - Phone: | 860-258-3480 |
Practice Address - Fax: | 860-571-6800 |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2006-10-27 |
Last Update Date: | 2024-03-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CT | 207KA0200X, 207RC0000X | |
207R00000X, 207RE0101X, 207RH0003X, 207RI0200X, 207RN0300X, 207RP1001X, 207RR0500X, 207V00000X, 213E00000X, 213ES0103X, 363AM0700X, 363L00000X, 367A00000X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 207R00000X | Allopathic & Osteopathic Physicians | Internal Medicine | Group - Multi-Specialty | |
No | 207KA0200X | Allopathic & Osteopathic Physicians | Allergy & Immunology | Allergy | Group - Multi-Specialty |
No | 207RC0000X | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease | Group - Multi-Specialty |
No | 207RE0101X | Allopathic & Osteopathic Physicians | Internal Medicine | Endocrinology, Diabetes & Metabolism | Group - Multi-Specialty |
No | 207RH0003X | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology & Oncology | Group - Multi-Specialty |
No | 207RI0200X | Allopathic & Osteopathic Physicians | Internal Medicine | Infectious Disease | Group - Multi-Specialty |
No | 207RN0300X | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology | Group - Multi-Specialty |
No | 207RP1001X | Allopathic & Osteopathic Physicians | Internal Medicine | Pulmonary Disease | Group - Multi-Specialty |
No | 207RR0500X | Allopathic & Osteopathic Physicians | Internal Medicine | Rheumatology | Group - Multi-Specialty |
No | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Group - Multi-Specialty | |
No | 213E00000X | Podiatric Medicine & Surgery Service Providers | Podiatrist | Group - Multi-Specialty | |
No | 213ES0103X | Podiatric Medicine & Surgery Service Providers | Podiatrist | Foot & Ankle Surgery | Group - Multi-Specialty |
No | 363AM0700X | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical | Group - Multi-Specialty |
No | 363L00000X | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Group - Multi-Specialty | |
No | 367A00000X | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | Group - Multi-Specialty |
Provider Identifiers
State | Identifier ID | ID Type | Issuer |
---|---|---|---|
CT | 004239697 | Medicaid | |
CT | 004170833 | Medicaid | |
CT | 004203402 | Medicaid | |
CT | 004218211 | Medicaid | |
CT | 500000245 | Medicaid | |
CT | 008040945 | Medicaid | |
CT | 004170833 | Medicaid |