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Organization

COMPREHENSIVE MEDICAL GROUP, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MARY E. AMATO (PRACTICE MANAGER)
(860) 673-3737
Entity
Organization

Contact information

Practice address
40 DALE RD, SUITE 103, AVON, CT 06001-3692
(860) 673-3737
(860) 675-0640
Mailing address
40 DALE RD, SUITE 103, AVON, CT 06001-3692
(860) 673-3737
(860) 675-0640

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
002626
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1669496113
MARY LEAHY, APRN NPI
CT
01
1942352794
DR. LALRUKH MUFTI NPI
CT
Enumeration date
03/21/2011
Last updated
11/15/2011
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