Organization
GREENWICH MEDICAL GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAIL M FENNELL M.D. (MANAGING PARTNER)
(203) 869-6960
Entity
Organization
Contact information
Practice address
75 HOLLY HILL LN, GREENWICH, CT 06830-6098
(203) 869-6960
(203) 869-5103
Mailing address
75 HOLLY HILL LN, GREENWICH, CT 06830-6098
(203) 869-6960
(203) 869-5103
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
AA2470348
CT
207R00000X
Internal Medicine Physician
AS8735308
CT
207R00000X
Internal Medicine Physician
BF4323503
CT
207R00000X
Internal Medicine Physician
BL9582493
CT
207R00000X
Internal Medicine Physician
Primary
BV5838959
CT
207RC0000X
Cardiovascular Disease Physician
BN3275369
CT
207RP1001X
Pulmonary Disease Physician
AM6000715
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00439394R
—
CT
Enumeration date
10/09/2006
Last updated
09/11/2025
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