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Contact Information

CITYBLOCK MEDICAL PRACTICE CT, P.C.
76 CENTER ST FL 3
WATERBURY, CT06702-2129
 Phone: 203-518-4566
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Psychiatry

2084P0800X 26 Physician/Psychiatry
Indicates primary specialty

NPI Profile & details for CITYBLOCK MEDICAL PRACTICE CT, P.C.

NPI # 1396218293
LBN Legal business name CITYBLOCK MEDICAL PRACTICE CT, P.C.
Authorized official JONATHAN ITSKOV - (CREDENTIALING)
Entity Organization
Organization subpart 1 No
Enumeration date 01/03/2019
Last updated 02/06/2019 - About 7 years ago
Identifiers n/a
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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