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Organization
FAIRFIELD COUNTY HEALTH & WELLNESS SERVICES II LLC
Active
Organization
FAIRFIELD COUNTY HEALTH & WELLNESS SERVICES II LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PROF. CARINE JEAN MD (OWNER/MD)
(203) 671-3587
Entity
Organization
Contact information
Practice address
325 REEF ROAD/SUITE 109, FAIRFIELD, CT 06824
(203) 955-1821
(203) 955-1823
Mailing address
21 MAPLE RIDGE RD, TRUMBULL, CT 06611-5522
(203) 671-3587
(203) 671-3587
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
Primary
033954
CT
2084P0802X
Addiction Psychiatry Physician
033954
CT
261QM0850X
Adult Mental Health Clinic/Center
033954
CT
Other
Enumeration date
06/06/2017
Last updated
06/06/2017
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