Organization
STONY CREEK MEDICAL GROUP, LLC
Active
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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