Organization
NEMG GASTROENTEROLOGY LLC
Active
Parent organization
NORTHEAST MEDICAL GROUP, INC.
Other names
Fairfield County Endoscopy Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
NORTHEAST MEDICAL GROUP, INC.
Authorized official
DR. EDWIN G LEVINE M.D. (MEDICAL DIRECTOR)
(203) 268-1193
Entity
Organization
Contact information
Practice address
888 WHITE PLAINS RD, SUITE 210, TRUMBULL, CT 06611-4552
(203) 268-1193
(203) 268-4009
Mailing address
888 WHITE PLAINS RD, SUITE 210, TRUMBULL, CT 06611-4552
(203) 268-1193
(203) 268-4009
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
0347
CT
Other
Enumeration date
05/06/2015
Last updated
03/21/2016
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