Healthcare Provider Details

I. General information

NPI: 1710436308
Provider Name (Legal Business Name): NEW ENGLAND INTEGRATED PRIMARY CARE, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2016
Last Update Date: 09/26/2025
Certification Date: 09/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 MAIN ST STE 1
EAST HAVEN CT
06512-3042
US

IV. Provider business mailing address

190 MAIN ST
EAST HAVEN CT
06512-3042
US

V. Phone/Fax

Practice location:
  • Phone: 203-983-9839
  • Fax:
Mailing address:
  • Phone: 203-467-2102
  • Fax: 203-467-1859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number49216
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number49216
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207RH0002X
TaxonomyHospice and Palliative Medicine (Internal Medicine) Physician
License Number49216
License Number StateCT

VIII. Authorized Official

Name: DR. ANN CELESTE DIMAYA
Title or Position: OWNER/M.D.
Credential: M.D.
Phone: 347-463-8527