MEDICARE: INTRASPECTUS, LLC

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
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)	005553	CT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	333779	OTHER	CT	MHN
2	140005553CT01	OTHER	CT	BCBS

General Provider Information

NPI Number	:	1942274618
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTRASPECTUS, LLC

Provider Business Mailing Address
First Line	:	93 LYON ST
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06511-4925
Country	:	US
Telephone Number	:	203-676-0880
Fax Number	:

Provider Business Practice Location Address
First Line	:	93 LYON ST
Second Line	:
City	:	NEW HAVEN
State	:	CT
Zip	:	06511-4925
Country	:	US
Telephone Number	:	203-676-0880
Fax Number	:

Authorized Official
Title or Position	:	MANAGING MEMBER
Name	:	MR. JEFFREY PAUL KEREKES
Credential	:	MSSW, LCSW
Telephone Number	:	203-676-0880

Provider Enumeration Date	:	02/17/2006
Last Update Date	:	08/22/2020

Similar Medicare Providers

1215098041 — MR. JEFFREY PAUL KEREKES MSSW, LCSW
Practice Location Address:

93 LYON ST
NEW HAVEN, CT
06511-4925

Practice Phone: 203-676-0880
Practice Fax:

1255640959 — JEFFREY KEREKES LLC
Practice Location Address:

43 LYON ST
NEW HAVEN, CT
06511-4925

Practice Phone: 203-676-0880
Practice Fax:

1689642704 — JOEL J BAUER MD
Practice Location Address:

25 EAST 69TH STREET
NEW YORK, NY
10021-4925

Practice Phone: 212-517-8600
Practice Fax: 212-535-3717

1083654503 — LIBERTY ORTHOTICS, INC.
Practice Location Address:

1201 2ND AVE
NEW HYDE PARK, NY
11040-4925

Practice Phone: 516-326-6786
Practice Fax: 516-326-6784

1306851621 — WALGREEN CO
Practice Location Address:

4200 WINNETKA AVE N
NEW HOPE, MN
55428-4925

Practice Phone: 763-545-6466
Practice Fax:

1427150044 — CONNIE J RICHTER LCSW
Practice Location Address:

4925 CHARLESTOWN RD
NEW ALBANY, IN
47150-9426

Practice Phone: 812-941-9200
Practice Fax: 812-941-9205

Directions to “INTRASPECTUS, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.