Unknown Individual – Psychiatry Physician, NPI 1609892645

Unknown Individual is a healthcare provider. based in Milford, Connecticut. specializing in Psychiatry Physician. They hold a License No. 151758 (NY). The NPI Number for Unknown Individual is 1609892645

Main info

Organization
Inactive
47 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1609892645
Phone
(212) 614-1011
Address
75 NEW HAVEN AVENUE
Deactivation Date
17 April 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9178873327
Graduation Year
1979 (47 years ago)
PAC ID
3476747536
Professional Enrollment ID
I20101102001146
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience23
Completeness75
Years active:0State licenses:2Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 75, New Haven Avenue, Fort Trumbull, Milford, South Central Connecticut Planning Region, Connecticut, 06460, United States

    MILFORD, CT 064604854

    Phone: (212) 614-1011

    Fax: (203) 389-9896

    Type: Location

  • 30, Barberry Lane, Woodbridge, South Central Connecticut Planning Region, Connecticut, 06525, United States

    WOODBRIDGE, CT 065251326

    Phone: (203) 397-2181

    Fax: (203) 389-9896

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06460)

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Reviews

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Frequently asked questions

What number should I use to identify Unknown Individual for billing?
Administrative and clinical systems typically use NPI 1609892645 for Unknown Individual.
Should I call the clinic if Unknown Individual is inactive here?
If Unknown Individual looks inactive here, cross-check state licensing and the clinic website.
What does the directory say Unknown Individual does?
Insurance directories may phrase it differently, but here Unknown Individual maps to Psychiatry Physician. Clinical services aligned with this taxonomy classification.
Is Unknown Individual tied to Milford, Connecticut?
If you are local to Milford, Connecticut, Unknown Individual may be relevant to your search.
Can I export Unknown Individual's record?
You can download the official NPPES record; we summarize key fields for readability.