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PREMISE HEALTH OF CONNECTICUT MEDICAL P.C. NPI 1437805348


NPI Information

NPI: 1437805348
Provider Name: PREMISE HEALTH OF CONNECTICUT MEDICAL, P.C.

Doing Business As: THE WELLNESS CENTER OPERATED BY PREMISE HEALTH

Classification: Clinic/Center - 261QM1300X
Entity Type: Organization

Specialization: Multi-Specialty

CLIA Number: 07D2260276

Address:
6900 MAIN ST
STRATFORD, CT
ZIP 06614
Phone: (203) 386-6488
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PREMISE HEALTH OF CONNECTICUT MEDICAL, P.C. is a multi-specialty clinic center in Stratford, CT. PREMISE HEALTH OF CONNECTICUT MEDICAL, P.C. NPI is 1437805348. The provider is registered as an organization entity type.
The provider Is Doing Business As The Wellness Center Operated By Premise Health.

The provider's business location address is:

6900 MAIN ST
STRATFORD, CT
ZIP 06614-378
Phone: (203) 386-6488

The provider's authorized official is Jon Leizman .
The authorized official title is President and has the following contact phone number (216) 479-9063.

The CLIA number assigned to this NPI record is 07D2260276 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/1/2022 and was last updated on 8/15/2022.


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
1261QM1300XClinic/CenterMulti-SpecialtyYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.