Organization
MEDICAL SPECIALISTS OF FAIRFIELD, LLC
Active
Other names
SWIM Hematology Oncology
Organization subpart
No
Provider details
NPI number
Authorized official
GLEN REZNIKOFF MD (MANAGING PARTNER)
(203) 255-4545
Entity
Organization
Contact information
Practice address
2800 MAIN ST, 3RD FLR, BRIDGEPORT, CT 06606-4201
(203) 382-2475
(203) 382-2488
Mailing address
425 POST RD, SOUTH LOBBY, FAIRFIELD, CT 06824-6232
(203) 255-4545
(203) 254-1191
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
—
—
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004082666
—
CT
01
—
010013862CT01
BCBS CT
CT
01
—
104363800
DEPT OF LABOR
CT
01
—
S2G58
BCBS NY
NY
Enumeration date
01/06/2006
Last updated
04/16/2014
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