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General NPI Number Information
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NPI Number | 1164255634
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Entity Type | Organization
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Legal Business Name | NEW ENGLAND MEDICAL WEIGHTLOSS CENTER PLLC
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Dates
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Enumeration Date | 08/21/2024
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Last Update Date | 08/21/2024
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Provider Practice Location Address
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Address Line | 4 DEARFIELD DR
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City | GREENWICH
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State | CT
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Zip | 06831-5351
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Country | US
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Telephone | 480-619-3062
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Fax |
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Provider Business Mailing Address
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Address Line | 3 ETON PL
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City | FARMINGTON
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State | CT
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Zip | 06032-1546
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Country | US
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Telephone | 480-619-3062
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MANSOOR A SHEIKH
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Credential | MD
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Telephone | 480-619-3062
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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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 | 207RB0002X
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Taxonomy Name | Obesity Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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