Unknown Individual – Neurology Physician, NPI 1942207394

Neurology Physician

Unknown Individual is a healthcare provider. based in Southington, Connecticut. specializing in Neurology Physician. They hold a License No. 041886 (CT). The NPI Number for Unknown Individual is 1942207394

Main info

Organization

Inactive

49 Years Of Experience

Accepts Medicare Assignment

Name

Unknown Individual

NPI

1942207394

Phone

(860) 621-1896

Address

462 QUEEN ST

Deactivation Date

21 June 2021

Doctor Profile

Medical School Name

OTHER

Secondary Phone

8606211896

Graduation Year

1977 (49 years ago)

PAC ID

7618962879

Group Practice PAC ID

3173866241

Professional Enrollment ID

I20040416001202

Data current as of

19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience14

Completeness75

Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

462, Queen Street, Southington, Hartford County, Connecticut, 06489, United States
STE 201
SOUTHINGTON, CT 064891801
Phone: (860) 621-1896
Type: Mailing
Hartford Hospital, 80, Seymour Street, Frog Hollow Historic District, Hartford, Hartford County, Connecticut, 06102, United States
HARTFORD HOSPITAL NEUROLOGY DEPT
HARTFORD, CT 061028000
Phone: (860) 545-3621
Type: Location

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.

This can happen when there are no reportable CMS Open Payments records.

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.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

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 06489)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.

PAC ID: 3173866241View full group profile

Name	Specialty	State
JENNY ANN RICE (PA-C)	-	CT
ABIGAIL L KLEIN (APRN)	Nurse Practitioner	CT
ASHLEY ANTONUCCI (DNP- FNP)	Nurse Practitioner	CT
MARLENE SCHWARTZ (M.D.)	-	CT
DR. EDWARD STANLEY SAWICKI (MD)	-	CT
DR. CRAIG D SWEENEY (MD)	-	CT
DR. MANDEEP KUMAR (M.D.)	Internal Medicine	CT
MR. MANUEL ALFREDO MOYA TAPIA (M.D.)	Internal Medicine	CT
KYLIE A GARGANO (APRN)	Nurse Practitioner	CT
DR. ANEESH TOLAT (M.D.)	Cardiac Electrophysiology, Cardiovascular Disease (Cardiology)	CT