Healthcare Provider Details

I. General information

NPI: 1124773858
Provider Name (Legal Business Name): BSS MD CT PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2022
Last Update Date: 02/22/2022
Certification Date: 02/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1423 CHAPEL ST
NEW HAVEN CT
06511-4411
US

IV. Provider business mailing address

30 BUXTON FARM RD
STAMFORD CT
06905-1224
US

V. Phone/Fax

Practice location:
  • Phone: 203-658-6051
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: STEVEN MURPHY
Title or Position: OWNER
Credential:
Phone: 203-554-8166