MATRIX PERSONALIZED MEDICINE LLC NPI 1194454603

NPI Information

  • NPI: 1194454603
  • Provider Name: MATRIX PERSONALIZED MEDICINE LLC
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Organization
  • CLIA Number: 07D2129177
  • Address: 45 GROVE ST
    NEW CANAAN, CT
    ZIP 06840
  • Phone: (203) 920-1772

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NPI Details

MATRIX PERSONALIZED MEDICINE LLC is a family medicine in New Canaan, CT. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MATRIX PERSONALIZED MEDICINE LLC NPI is 1194454603. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

45 GROVE ST
NEW CANAAN, CT
ZIP 06840-330
Phone: (203) 920-1772

The provider's authorized official is Lawrence Leibowitz .
The authorized official title is Md and has the following contact phone number (203) 920-1772.

The CLIA number assigned to this NPI record is 07D2129177 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/9/2022 and was last updated on 6/9/2022.

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
1207Q00000XFamily MedicineYes

What is NPI?

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This page was last updated on: 11/21/2025

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