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FAIRFIELD COUNTY MEDICAL GROUP PC NPI 1639195415


NPI Information

NPI: 1639195415
Provider Name: FAIRFIELD COUNTY MEDICAL GROUP, PC
Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 07D0887337

Address:
15 CORPORATE DR
SUITE 2-1
TRUMBULL, CT
ZIP 06611
Phone: (203) 459-5100
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FAIRFIELD COUNTY MEDICAL GROUP, PC is an internal medicine in Trumbull, CT. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. FAIRFIELD COUNTY MEDICAL GROUP, PC NPI is 1639195415. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

15 CORPORATE DR
SUITE 2-1
TRUMBULL, CT
ZIP 06611-351
Phone: (203) 459-5100
Fax: (203) 452-2424

The provider's authorized official is Frank Spano .
The authorized official title is President and has the following contact phone number (203) 459-5100.

The CLIA number assigned to this NPI record is 07D0887337 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/14/2006 and was last updated on 4/20/2008.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal Medicine028987CONNECTICUTYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1=========OTHERCONNECTICUTAETNA
2=========OTHERCONNECTICUTCONNECTICARE , INC & AFFI
3I01335MEDICARE UPINCONNECTICUT
4B39629MEDICARE UPINCONNECTICUT
5E44796MEDICARE UPINCONNECTICUT
6H57774MEDICARE UPINCOLORADO
7C01579MEDICARE ID-TYPE UNSPECIFIEDCONNECTICUT
8C12675OTHERCONNECTICUTRAILROAD MEDICARE PTAN
9F26975MEDICARE UPINCONNECTICUT
10=========OTHERCONNECTICUTUNITED HEALTH CARE
11=========OTHERCONNECTICUTCIGNA HEALTHCARE OF CT
12S53756MEDICARE UPINCONNECTICUT
13H54952MEDICARE UPINCONNECTICUT
1450FFLDCMGCT01OTHERCONNECTICUTANTHEM BLUE CROSS BLUE SH
15=========OTHERCOLORADOOXFORD HEALTH PLANS

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: 4/28/2024

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.