Organization
GREATER BRIDGEPORT DIAGNOSTICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EUGENE H LEWIS III D.O. (PRESIDENT)
(203) 576-5032
Entity
Organization
Contact information
Practice address
2800 MAIN ST, BRIDGEPORT, CT 06606-4201
(203) 576-5032
(203) 576-5034
Mailing address
PO BOX 810, NEW HAVEN, CT 06503-0810
(203) 397-8000
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
—
—
Other
Enumeration date
10/20/2015
Last updated
10/20/2015
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