Healthcare Provider Details

I. General information

NPI: 1780790501
Provider Name (Legal Business Name): EFK OF CONNECTICUT, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

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

III. Provider practice location address

208 QUINNIPIAC AVE
NORTH HAVEN CT
06473-3626
US

IV. Provider business mailing address

PO BOX 188
NORTH HAVEN CT
06473-0188
US

V. Phone/Fax

Practice location:
  • Phone: 203-333-9433
  • Fax:
Mailing address:
  • Phone: 203-333-9433
  • Fax: 203-752-9341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License NumberL015P3
License Number StateCT

VIII. Authorized Official

Name: MR. MARK JOSEPH PANICO
Title or Position: VICE PRESIDENT
Credential:
Phone: 203-333-9433