Organization
TOWN OF FAIRFIELD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SANDS CLEARY (DIRECTOR)
(203) 256-3020
Entity
Organization
Contact information
Practice address
100 MONA TERRACE, FAIRFIELD, CT 06824-6684
(203) 256-3150
(203) 256-3172
Mailing address
725 OLD POST RD, FAIRFIELD, CT 06824-6684
(203) 256-3020
(203) 254-8850
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68VNA0052CT01
ANTHEM
CT
Enumeration date
12/29/2006
Last updated
10/06/2016
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