Richard Siahaan, M.D.
Internal Medicine in Bloomfield, CT. Individual provider (NPI-1).
NPI number1013133628
StatusActive
Last updated in NPPESDec 28, 2016
Details
- NPI
- 1013133628
- Entity type
- Individual (NPI-1)
- Name
- Richard Siahaan
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 18, 2007
- Last updated
- Dec 28, 2016
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | 24303 | CT | Yes |
| 207R00000X | Internal Medicine | 024303 | CT |
Practice location
421 Cottage Grove RdBloomfield, CT 06002-3170
Phone 860-242-0034 · Fax 860-242-3301
Mailing address
421 Cottage Grove RdBloomfield, CT 06002-3170
Phone 860-242-0034 · Fax 860-242-3301
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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