Cityblock Medical Practice CT, P.C.
NPI 1396218293ActiveOrganization· Internal Medicine· Waterbury, CT
Internal Medicine in Waterbury, Connecticut, registered in NPPES in January 2019. The authorized official on file is Jonathan Itskov, Credentialing.
Overview
| NPI | 1396218293 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Jan 3, 2019 |
| Last updated in NPPES | Feb 6, 2019 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Internal Medicine Primary | 207R00000X | — | — |
| Family Medicine | 207Q00000X | — | — |
| Psychiatry & Neurology, Psychiatry | 2084P0800X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
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