Organization
GENESIS MEDICA URGENT CARE GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TERRY CHOSZCZYK (MANAGER)
(203) 865-3880
Entity
Organization
Contact information
Practice address
1427 CHAPEL ST, NEW HAVEN, CT 06511-4403
(203) 865-3880
Mailing address
1427 CHAPEL ST, NEW HAVEN, CT 06511-4403
(203) 865-3880
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
036883
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1912927658
INDIVIDUAL NPI
CT
Enumeration date
10/04/2017
Last updated
06/16/2018
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