# MOUNT MORIAH MEDICAL CENTER, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1558308445
- **Authorized official:** DR. HAROLD PHILLIPS JR. M.D. (PHYSICIAN/OWNER)
- **Authorized official phone:** (860) 460-2183

## Contact information

- **Practice address:** 435 MONTAUK AVE, NEW LONDON, CT 06320-4621
- **Practice address phone:** (860) 444-7400
- **Practice address fax:** (860) 444-7401
- **Mailing address:** 196 PARKWAY S, SUITE 304, WATERFORD, CT 06385-1219
- **Mailing address phone:** (860) 442-7027
- **Mailing address fax:** (860) 444-0074

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/01/2006
- **Last updated:** 09/04/2007