Organization
FOENIX MEDICAL CONSULTING PLLC
Active
Organization
FOENIX MEDICAL CONSULTING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAIYE OGUNDIPE MD (MANAGER)
(860) 918-8859
Entity
Organization
Contact information
Practice address
1 TURKEY HILL RD S STE 100, WESTPORT, CT 06880-5525
(860) 918-8859
Mailing address
1449 WHALLEY AVE UNIT 3787, NEW HAVEN, CT 06525-7716
(860) 918-8859
Taxonomy
Speciality
Code
Description
License number
State
2084A0401X
Addiction Medicine (Psychiatry & Neurology) Physician
—
—
2084B0002X
Obesity Medicine (Psychiatry & Neurology) Physician
—
—
2084F0202X
Forensic Psychiatry Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
2084P0804X
Child & Adolescent Psychiatry Physician
—
—
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
—
—
Other
Enumeration date
02/20/2019
Last updated
03/05/2019
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