Provider Demographics
NPI:1710436308
Name:NEW ENGLAND INTEGRATED PRIMARY CARE, INC.
Entity Type:Organization
Organization Name:NEW ENGLAND INTEGRATED PRIMARY CARE, INC.
Other - Org Name:NEW ENGLAND INTEGRATED PRIMARY CARE
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER/M.D.
Authorized Official - Prefix:DR
Authorized Official - First Name:ANN CELESTE
Authorized Official - Middle Name:
Authorized Official - Last Name:MAPAS-DIMAYA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:347-463-8527
Mailing Address - Street 1:190 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06512-3042
Mailing Address - Country:US
Mailing Address - Phone:203-467-2102
Mailing Address - Fax:203-467-1859
Practice Address - Street 1:190 MAIN ST
Practice Address - Street 2:STE 1
Practice Address - City:EAST HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06512-3042
Practice Address - Country:US
Practice Address - Phone:203-983-9839
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-24
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT49216207R00000X, 207RG0300X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Multi-Specialty
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008070777Medicaid
CTD400032402Medicare PIN