Organization
FAMILY PRACTICE & INTERNAL MEDICINE OF SPRING GREN LLC
Active
Organization
FAMILY PRACTICE & INTERNAL MEDICINE OF SPRING GREN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. FAUSTO PETEUZZIELLO MD (PHYSICIAN OWNER)
(203) 407-6410
Entity
Organization
Contact information
Practice address
2200 WHITHEY AVE, SUITE 100, HAMDEH, CT 06518
(203) 407-6410
(203) 407-6433
Mailing address
2200 WHITHEY AVE, SUITE 100, HAMDEH, CT 06518
(203) 407-6410
(203) 407-6433
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG7487
RRM
—
Enumeration date
06/07/2006
Last updated
08/22/2020
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