Healthcare Provider Details
I. General information
NPI: 1487367199
Provider Name (Legal Business Name): QMG7,LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/28/2022
Last Update Date: 01/30/2025
Certification Date: 01/30/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
527 ELM ST
NEW HAVEN CT
06511-4549
US
IV. Provider business mailing address
389 BRIDGEPORT AVE
SHELTON CT
06484-5380
US
V. Phone/Fax
- Phone: 475-321-5150
- Fax:
- Phone: 475-321-5150
- Fax: 203-292-7026
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
STEVEN
HEFFER
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 475-321-5150