Healthcare Provider Details

I. General information

NPI: 1437546363
Provider Name (Legal Business Name): QMG2,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/17/2015
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1910 BLACK ROCK TPKE
FAIRFIELD CT
06825-3543
US

IV. Provider business mailing address

201 WHITES HILL LN
FAIRFIELD CT
06824-2177
US

V. Phone/Fax

Practice location:
  • Phone: 203-333-4400
  • Fax: 203-292-7026
Mailing address:
  • Phone: 203-675-1345
  • Fax: 203-292-7026

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number038137
License Number StateCT

VIII. Authorized Official

Name: DR. STEVEN HEFFER
Title or Position: PARTNER
Credential: M.D.
Phone: 203-675-1345