Organization
BEACON FALLS MEDICAL ASSOCIATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSE R ORELLANA (PRESIDENT)
(203) 729-6644
Entity
Organization
Contact information
Practice address
202 WATER ST, NAUGATUCK, CT 06770-2803
(203) 729-6644
Mailing address
202 WATER ST, NAUGATUCK, CT 06770-2803
(203) 729-6644
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
035801
CT
207RG0100X
Gastroenterology Physician
Primary
035834
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50BEFALLSCT01
ANTHEM BC/BS
CT
01
—
CG6464
RAILROAD MEDICARE
CT
Enumeration date
07/14/2006
Last updated
08/22/2020
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