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Organization
FAIRFIELD COUNTY PRIMARY CARE, PC
Active
Organization
FAIRFIELD COUNTY PRIMARY CARE, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN RODIS MD (AUTHORIZED OFFICIAL)
(203) 372-1900
Entity
Organization
Contact information
Practice address
345 MAIN AVE, NORWALK, CT 06851-1547
(203) 849-7777
(203) 846-4477
Mailing address
345 MAIN AVE, NORWALK, CT 06851-1547
(203) 849-7777
(203) 846-4477
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
NULL
207P00000X
Emergency Medicine Physician
—
—
207QA0505X
Adult Medicine Physician
Primary
—
NULL
207QA0505X
Adult Medicine Physician
Primary
—
—
208D00000X
General Practice Physician
—
NULL
208D00000X
General Practice Physician
—
—
Other
Enumeration date
12/15/2009
Last updated
12/15/2009
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