Healthcare Provider Details

I. General information

NPI: 1457809527
Provider Name (Legal Business Name): MOBILE CARE SOLUTIONS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2016
Last Update Date: 09/19/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

67 HOLLY HILL LN STE 102
GREENWICH CT
06830-6072
US

IV. Provider business mailing address

67 HOLLY HILL LN STE 102
GREENWICH CT
06830-6072
US

V. Phone/Fax

Practice location:
  • Phone: 203-869-5515
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. GLENN GANDELMAN
Title or Position: SOLE OWNER
Credential: M.D.
Phone: 203-869-5515