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Organization
GREENWICH UROLOGICAL ASSOC P C
Active
Organization
GREENWICH UROLOGICAL ASSOC P C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALISON MILLER (OFFICE MANAGER)
(203) 869-1285
Entity
Organization
Contact information
Practice address
49 LAKE AVE, GREENWICH, CT 06830
(203) 869-1285
(203) 869-1959
Mailing address
49 LAKE AVE, GREENWICH, CT 06830-4501
(203) 869-1285
(203) 869-1959
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB1637
RAILROAD MEDICARE GROUP
—
Enumeration date
12/15/2005
Last updated
06/27/2018
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