IndividualActive
Chin Cheng Tai
NPI 1417300112 · Primary Care Nurse Practitioner · Southbury, CT
Provider details
- NPI number
- 1417300112
- Entity type
- Individual
- Primary specialty
- Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Male
- Sole proprietor
- Yes
- License
- 307846 (NY)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Physician Assistants & Advanced Practice Nursing Providers
Practice location
49 Peter Rd Ste 3
Southbury, CT 06488-2681
Phone: (860) 590-9592
Approximate (ZIP-level) locationGet directions
Mailing address
58 Overton Farm Rd
Southbury, CT 06488-2403
Registry dates
- Enumerated
- 2016-07-18
- Last updated
- 2025-08-27
- Certified
- 2025-08-27
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.