Dr Benjamin Hall Roberts, MD | |
226 Dixwell Ave, Pediatrics, New Haven, CT 06511-3456 | |
(203) 503-3420 | |
(203) 503-3422 |
Full Name | Dr Benjamin Hall Roberts |
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Gender | Male |
Speciality | Pediatrics |
Location | 226 Dixwell Ave, New Haven, Connecticut |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1972775039 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 064258 (Georgia) | Secondary |
208000000X | Pediatrics | 002538 (Georgia) | Secondary |
208000000X | Pediatrics | 687716 (Connecticut) | Primary |
Entity Name | The Southeast Permanente Medical Group |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1245266956 PECOS PAC ID: 6204829013 Enrollment ID: O20040407000370 |
Mailing Address | Practice Location Address |
---|---|
Dr Benjamin Hall Roberts, MD 400 Columbus Ave, Credentialing, New Haven, CT 06519-1233 Ph: (203) 503-3000 | Dr Benjamin Hall Roberts, MD 226 Dixwell Ave, Pediatrics, New Haven, CT 06511-3456 Ph: (203) 503-3420 |
Dr. Yeisid F Figueredo, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 20 York St, Dept Of Neonatology, New Haven, CT 06510 Phone: 203-688-2320 | |
Ruchika S Karnik, MD Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1 Park St, New Haven, CT 06504 Phone: 203-785-4081 | |
Dr. Danice Kuruvilla, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1 Park St, New Haven, CT 06504 Phone: 203-785-4081 | |
Thomas Garrett Flynn, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 800 Howard Ave, Yale Physicians Bldg, New Haven, CT 06519 Phone: 203-785-2140 Fax: 203-785-6414 | |
Caitlin Elizabeth Hansen, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 20 York St, New Haven, CT 06510 Phone: 203-785-4730 Fax: 203-785-6961 | |
Trupti Ingle, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 20 York St, New Haven, CT 06510 Phone: 203-688-4242 | |
Dr. Shamsa N Shafi, M.D. Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 20 York St, New Haven, CT 06510 Phone: 203-688-4242 |