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Organization
NORTHEAST MEDICAL GROUP
Active
Organization
NORTHEAST MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CECILIA WALDRON (CREDENTIALING COORDINATOR)
(203) 688-1734
Entity
Organization
Contact information
Practice address
20 YORK ST, NEW HAVEN, CT 06510-3220
(203) 688-4242
Mailing address
226 MILL HILL AVE STE 3, BRIDGEPORT, CT 06610-2826
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
50684
CT
Other
Enumeration date
01/09/2015
Last updated
01/09/2015
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