Healthcare Provider Details

I. General information

NPI: 1841226347
Provider Name (Legal Business Name): NORWALK COMMUNITY HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/25/2006
Last Update Date: 04/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

120 CONNECTICUT AVENUE
NORWALK CT
06854-3013
US

IV. Provider business mailing address

120 CONNECTICUT AVENUE
NORWALK CT
06854-3013
US

V. Phone/Fax

Practice location:
  • Phone: 203-899-1770
  • Fax: 203-899-1769
Mailing address:
  • Phone: 203-899-1770
  • Fax: 203-899-1769

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number0522
License Number StateCT

VIII. Authorized Official

Name: MR. JOHN J GETTINGS III
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 203-899-1770