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General NPI Number Information
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NPI Number | 1427274844
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Entity Type | Organization
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Legal Business Name | MDSERVICES, LLC
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 09/03/2010
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Provider Practice Location Address
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Address Line | 10 N BENSON RD
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City | MIDDLEBURY
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State | CT
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Zip | 06762-3213
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Country | US
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Telephone | 203-758-1316
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Fax | 203-758-1976
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Provider Business Mailing Address
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Address Line | 10 N BENSON RD
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City | MIDDLEBURY
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State | CT
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Zip | 06762-3213
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Country | US
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Telephone | 203-758-1316
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Fax | 203-758-1976
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Authorized Official
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Title or Position | CPC, BILLING
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Name | MRS. TERRI RUSSOLILLO
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Credential |
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Telephone | 203-758-1316
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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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