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General NPI Number Information
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NPI Number | 1013270289
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Entity Type | Organization
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Legal Business Name | MY HEALTH 1ST URGENT CARE LLC
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Dates
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Enumeration Date | 06/21/2012
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Last Update Date | 01/14/2013
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Provider Practice Location Address
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Address Line | 470 BRIDGEPORT AVE # J
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City | MILFORD
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State | CT
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Zip | 06460-4167
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Country | US
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Telephone | 203-693-3676
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Fax | 203-876-9334
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Provider Business Mailing Address
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Address Line | 470 BRIDGEPORT AVE # J
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City | MILFORD
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State | CT
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Zip | 06460-4167
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Country | US
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Telephone | 203-693-3676
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Fax | 203-876-9334
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Authorized Official
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Title or Position | MEMBER
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Name | DR. AWAIS MALIK
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Credential | MD
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Telephone | 203-243-6018
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 049851
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 049851
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License Number State | CT
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