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General NPI Number Information
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NPI Number | 1295856714
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Entity Type | Organization
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Legal Business Name | LUNG ASSOCIATES OF CONNECTICUT, LLC
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Dates
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Enumeration Date | 04/02/2007
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 46 PRINCE ST
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City | NEW HAVEN
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State | CT
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Zip | 06519-1600
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Country | US
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Telephone | 203-923-7013
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Fax | 203-502-0119
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Provider Business Mailing Address
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Address Line | 46 PRINCE ST
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City | NEW HAVEN
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State | CT
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Zip | 06519-1600
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Country | US
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Telephone | 203-923-7013
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Fax | 203-502-0119
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MICHAEL IMEVBORE
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Credential | M.D.
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Telephone | 203-923-7013
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RP1001X
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Taxonomy Name | Pulmonary Disease Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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