Organization
STONY CREEK MEDICAL GROUP, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MAYUMI DEANNA NODA YOUNG (EXECUTIVE DIRECTOR)
(203) 483-4580
Entity
Organization
Contact information
Practice address
236 BOSTON POST RD, ORANGE, CT 06477-3236
(203) 815-1054
(203) 298-9874
Mailing address
6 BUSINESS PARK DR, SUITE 302, BRANFORD, CT 06405-2988
(203) 980-1359
(203) 483-4581
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
042996
CT
207R00000X
Internal Medicine Physician
Primary
041818
CT
208000000X
Pediatrics Physician
041818
CT
Other
Enumeration date
10/18/2013
Last updated
10/22/2013
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