Organization
EMERGENCY MEDICINE PHYSICIANS OF FAIRFIELD COUNTY, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID C PACKO MD (PRESIDENT)
(330) 493-4443
Entity
Organization
Contact information
Practice address
30 SHELBURNE RD, STAMFORD, CT 06902-3628
(330) 493-4443
(330) 493-8677
Mailing address
4535 DRESSLER RD NW, CANTON, OH 44718-2545
(330) 493-4443
(330) 493-8677
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
2080P0204X
Pediatric Emergency Medicine (Pediatrics) Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004225141
—
CT
05
—
02324707
—
NY
05
—
8902500
—
NJ
Enumeration date
06/07/2006
Last updated
06/25/2016
Update your record
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