FAIRFIELD COUNTY INTEGRATIVE FAMILY MEDICINE LLC NPI 1629239751

NPI Information

NPI: 1629239751
Provider Name: FAIRFIELD COUNTY INTEGRATIVE FAMILY MEDICINE LLC
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 07D1087350

Address:
2 CORPORATE DR
SUITE 110
TRUMBULL, CT
ZIP 06611
Phone: (203) 445-9060
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FAIRFIELD COUNTY INTEGRATIVE FAMILY MEDICINE LLC is a primary care clinic center in Trumbull, CT. FAIRFIELD COUNTY INTEGRATIVE FAMILY MEDICINE LLC NPI is 1629239751. The provider is registered as an organization entity type.

The provider's business location address is:

2 CORPORATE DR
SUITE 110
TRUMBULL, CT
ZIP 06611-376
Phone: (203) 445-9060
Fax: (203) 445-9093

The provider's authorized official is Tonya M Cremin .
The authorized official title is President/owner and has the following contact phone number (203) 521-3405.

The CLIA number assigned to this NPI record is 07D1087350 - physician office with a certificate type of Certificate for Provider-Performed Microscopy Procedures (PPMP).

The enumeration date for this NPI number is 6/20/2008 and was last updated on 12/17/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care	044753	CONNECTICUT	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	D100000031	MEDICARE PIN	CONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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