Organization
PRIMED LLC
Active
Organization
PRIMED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. AMIT RASTOGI MD (PRESIDENT, PRIMED LLC)
(203) 944-1940
Entity
Organization
Contact information
Practice address
4699 MAIN ST, SUITE 105 ATTN: MED3000, BRIDGEPORT, CT 06606-1830
(203) 944-1940
(203) 402-4196
Mailing address
3 ENTERPRISE DR, SUITE 404, SHELTON, CT 06484-4694
(203) 944-1940
(203) 402-4196
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
025538
CT
207RC0000X
Cardiovascular Disease Physician
—
—
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
—
—
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
207RI0200X
Infectious Disease Physician
—
—
207RP1001X
Pulmonary Disease Physician
—
—
207RS0012X
Sleep Medicine (Internal Medicine) Physician
—
—
207W00000X
Ophthalmology Physician
—
—
208000000X
Pediatrics Physician
—
—
208600000X
Surgery Physician
—
—
213E00000X
Podiatrist
000462
CT
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
470000038
MEDICARE FCSC
CT
Enumeration date
06/01/2006
Last updated
03/27/2013
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