Organization
STONY CREEK URGENT CARE CENTER, LLC
Active
Parent organization
STONY CREEK VENTURES, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
STONY CREEK VENTURES, LLC
Authorized official
DR. DAVID J YOUNG MD (MANAGING MEMBER)
(203) 483-4580
Entity
Organization
Contact information
Practice address
6 BUSINESS PARK DR, SUITE 302, BRANFORD, CT 06405-2988
(203) 483-4580
(203) 483-4581
Mailing address
6 BUSINESS PARK DR, SUITE 302, BRANFORD, CT 06405-2988
(203) 483-4580
(203) 483-4581
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
208000000X
Pediatrics Physician
—
—
208D00000X
General Practice Physician
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
363LF0000X
Family Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
68WLKN042CT02
ANTHEMBCBS
CT
01
—
D100000134
MEDICARE PTAN
—
Enumeration date
07/15/2008
Last updated
02/24/2015
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