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NPI Code Detail

MEDICARE: DR. TED LISTOKIN M.D.

MEDICARE: DR. TED LISTOKIN M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine Physician036931CT

General Provider Information

NPI Number : 1144395716
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TED LISTOKIN M.D.
Provider Business Mailing Address
First Line : 1450 WASHINGTON BLVD
Second Line :
City : STAMFORD
State : CT
Zip : 06902-2451
Country : US
Telephone Number : 203-327-9321
Fax Number : 203-967-2140
Provider Business Practice Location Address
First Line : 1450 WASHINGTON BLVD
Second Line :
City : STAMFORD
State : CT
Zip : 06902-2451
Country : US
Telephone Number : 203-327-9321
Fax Number : 203-967-2140
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/21/2006
Last Update Date : 01/08/2014

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Directions to “ DR. TED LISTOKIN M.D.” Practice Location

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