Organization
INTERNAL MEDICINE OF EAST HAVEN PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK SHERARD KASPER MD (PRESIDENT)
(203) 468-9775
Entity
Organization
Contact information
Practice address
339 HEMINGWAY AVE, EAST HAVEN, CT 06512-2318
(203) 468-9775
Mailing address
339 HEMINGWAY AVE, EAST HAVEN, CT 06512-2318
(203) 468-9775
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
024588
CT
174400000X
Specialist
024717
CT
174400000X
Specialist
030998
CT
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001309980
—
CT
Enumeration date
03/31/2006
Last updated
06/05/2019
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