Organization
MOUNT MORIAH MEDICAL CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HAROLD PHILLIPS JR. M.D. (PHYSICIAN/OWNER)
(860) 460-2183
Entity
Organization
Contact information
Practice address
435 MONTAUK AVE, NEW LONDON, CT 06320-4621
(860) 444-7400
(860) 444-7401
Mailing address
196 PARKWAY S, SUITE 304, WATERFORD, CT 06385-1219
(860) 442-7027
(860) 444-0074
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CH6914
RAILD ROAD MEDICARE GROUP
CT
Enumeration date
06/01/2006
Last updated
09/04/2007
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