Healthcare Provider Details

I. General information

NPI: 1609856178
Provider Name (Legal Business Name): U.S. HEALTHWORKS MEDICAL GROUP OF CONNECTICUT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

144 N MAIN ST
BRANFORD CT
06405-3044
US

IV. Provider business mailing address

3655 N POINT PKWY SUITE 150
ALPHARETTA GA
30005-2025
US

V. Phone/Fax

Practice location:
  • Phone: 203-481-0818
  • Fax:
Mailing address:
  • Phone: 770-772-6282
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: JOE MALLAS
Title or Position: SENIOR VP
Credential:
Phone: 770-772-6282