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General NPI Number Information
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NPI Number | 1083854269
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Entity Type | Organization
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Legal Business Name | THE GARVIN GROUP DBA PASSPORT HEALTH
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Dates
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Enumeration Date | 02/27/2009
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Last Update Date | 02/27/2009
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Provider Practice Location Address
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Address Line | 1100 BEDFORD ST
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City | STAMFORD
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State | CT
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Zip | 06905-5305
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Country | US
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Telephone | 203-406-9655
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Fax | 203-406-9978
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Provider Business Mailing Address
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Address Line | 1100 BEDFORD ST
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City | STAMFORD
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State | CT
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Zip | 06905-5305
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Country | US
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Telephone | 203-406-9655
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Fax | 203-406-9978
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Authorized Official
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Title or Position | DIRECTOR
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Name | MS. BARBARA JAN-MEE WONG
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Credential | R.N.
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Telephone | 203-406-9655
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number |
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License Number State |
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