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Organization

LORI L. GREENWALD, MD, PC

Active
Other names
Vanishing Veins
Organization subpart
No

Provider details

NPI number
Authorized official
MS. SUSAN R MICHAUD (OFFICE MANAGER)
(860) 761-6666
Entity
Organization

Contact information

Practice address
1 BARNARD LN, SUITE 201, BLOOMFIELD, CT 06002-2481
(860) 761-6666
(860) 761-2502
Mailing address
1 BARNARD LN, SUITE 201, BLOOMFIELD, CT 06002-2481
(860) 761-6666
(860) 761-2502

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
030092
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
C03461
MEDICARE GROUP
Enumeration date
12/07/2007
Last updated
12/07/2007
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