Organization
SHORELINE MEDICAL ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JENNIFER P SWENSON M.D. (PHYSICIAN)
(203) 245-4933
Entity
Organization
Contact information
Practice address
1353 BOSTON POST RD, MADISON, CT 06443-3445
(203) 245-4933
(203) 245-4399
Mailing address
1353 BOSTON POST RD, MADISON, CT 06443-3445
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
363LF0000X
Family Nurse Practitioner
006159
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001222280
—
CT
05
—
001378422
—
CT
05
—
001421916
—
CT
Enumeration date
06/15/2005
Last updated
09/16/2015
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