Organization
MOUNT CARMEL INTERNAL MEDICINE AND GERIATRICS LLC
Active
Organization
MOUNT CARMEL INTERNAL MEDICINE AND GERIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARIA N.C. STACK M.D. (PRESIDENT)
(203) 699-9898
Entity
Organization
Contact information
Practice address
680 S MAIN ST, SUITE 205, CHESHIRE, CT 06410-3181
(203) 699-9898
(203) 250-7878
Mailing address
5000 BIRCH ST, NEWPORT BEACH, CA 92660-2127
(301) 990-3995
(702) 447-8174
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001285148
—
CT
Enumeration date
07/14/2005
Last updated
07/21/2022
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