Organization
CARDIOLOGY PHYSICIANS OF FAIRFIELD COUNTY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN GLECKLER (CFO)
(203) 576-5551
Entity
Organization
Contact information
Practice address
1177 SUMMER ST, STAMFORD, CT 06905-5572
(203) 353-1133
Mailing address
2800 MAIN ST, BRIDGEPORT, CT 06606-4201
(203) 576-5551
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
207RI0011X
Interventional Cardiology Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
06/07/2012
Last updated
11/05/2013
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