Healthcare Provider Details

I. General information

NPI: 1629899372
Provider Name (Legal Business Name): ACUBLEND PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/24/2024
Last Update Date: 10/24/2024
Certification Date: 10/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 HIGH RIDGE RD
STAMFORD CT
06905-1223
US

IV. Provider business mailing address

1200 HIGH RIDGE RD
STAMFORD CT
06905-1223
US

V. Phone/Fax

Practice location:
  • Phone: 203-987-6585
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number StateNULL

VIII. Authorized Official

Name: SIAN SHEENA JAMES
Title or Position: MEDICAL DIRECTOR
Credential: DACM
Phone: 203-987-6585