Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Southern Connecticut Geriatric & Preventive Medicine LLC

Organization Geriatric Medicine (Internal Medicine) Physician · NPI 1679701882

Southern Connecticut Geriatric & Preventive Medicine LLC is a Geriatric Medicine (Internal Medicine) Physician in New Haven, Connecticut. Licensed in Connecticut. Registered with an NPI since 2009.

Licensed in
CT
In the registry since
2009
Specialties on file
3
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

390 Livingston St
New Haven, CT 06511-1336
Phone: (203) 871-9224
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Geriatric Medicine (Internal Medicine) Physician (primary) Taxonomy 207RG0300X · Licence 041288 (CT)
Geriatric Medicine (Internal Medicine) Physician Taxonomy 207RG0300X
Public Health & General Preventive Medicine Physician Taxonomy 2083P0901X · Licence 041288 (CT)

Record details

NPI number1679701882
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Asefeh Heiat — Member · (203) 871-9224
NPI enumeratedJune 25, 2009
Last updated in NPPESOctober 4, 2021
Certification dateOctober 4, 2021
Mailing address390 Livingston St, New Haven, CT 06511-1336

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