Organization
SEAPORT CLINIC LLC
Active
Other names
Seaport Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MARIE ALTANA CHIARADIO (OFFICE MANAGER)
(860) 572-8282
Entity
Organization
Contact information
Practice address
56 WHITEHALL AVE, RT 27, MYSTIC, CT 06355
(860) 572-8282
(860) 572-7445
Mailing address
56 WHITEHALL AVE, RT 27, MYSTIC, CT 06355
(860) 572-8282
(860) 572-7445
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
10/05/2006
Last updated
08/22/2020
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