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Organization

BRIDGEPORT FAMILY MEDICINE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
AWAIS MALIK M.D.,CEO (MEDICAL DIRECTOR)
(203) 243-6018
Entity
Organization

Contact information

Practice address
754 CLINTON AVE, BRIDGEPORT, CT 06604
(203) 243-6018
Mailing address
112 SUNNYRIDGE AVE, FAIRFIELD, CT 06824-4620
(203) 243-6018

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
049851
CT
261QU0200X
Urgent Care Clinic/Center
049851
CT

Other

Enumeration date
06/18/2015
Last updated
06/18/2015
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