# PREMISE HEALTH OF CONNECTICUT MEDICAL, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Boehringer Ingelheim Occupational Health Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801491246
- **Authorized official:** DR. JON LEIZMAN MD (PRESIDENT)
- **Authorized official phone:** (216) 479-9063

## Contact information

- **Practice address:** 900 RIDGEBURY RD, RIDGEFIELD, CT 06877-1058
- **Practice address phone:** (203) 798-5605
- **Practice address fax:** (203) 837-5105
- **Mailing address:** 5500 MARYLAND WAY STE 120, BRENTWOOD, TN 37027-4993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QX0100X | Occupational Medicine Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 12/03/2020
- **Last updated:** 08/15/2022