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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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